Irritable bowel syndrome
Irritable bowel syndrome and comorbidities: Recognising connections and providing targeted treatment
The quality of life of people with irritable bowel syndrome ( ) is often severely impaired, not only by the variety of symptoms , but also by the frequent occurrence of accompanying diseases. In such cases, improving the general well-being of patients is essential.
Functional gastrointestinal comorbidities
Gastrointestinal disorders include a variety of functional disorders (without organic causes) of the digestive tract. The most common include:
- Functional dyspepsia: A chronic or recurrent digestive disorder characterised by upper abdominal symptoms such as bloating, pain or nausea, without any organic cause being found.
- Gastroesophageal reflux disease (GERD)
- Functional constipation
Extraintestinal comorbidities
In addition to gastrointestinal comorbidities, people with irritable bowel syndrome often experience extraintestinal comorbidities, including:
- Fibromyalgia
- Chronic fatigue syndrome (CFS)
- Chronic pelvic pain
Irritable bowel syndrome (IBS) and mental health conditions
Irritable bowel syndrome also frequently occurs in conjunction with mental disorders that manifest themselves in physical symptoms. Therefore, the psychological component should always be taken into account in the treatment of irritable bowel syndrome patients and treated therapeutically if necessary.
In IBS sufferers, increased chronic stress and a high comorbidity with affective disorders – especially with symptoms of anxiety and depression – are well documented. There is evidence of a close link, particularly in children. These psychological stresses can exacerbate gastrointestinal symptoms.
In the biopsychosocial disease model, chronic stress and psychiatric comorbidities are considered central risk factors for the development and maintenance of irritable bowel syndrome.
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- Layer P et al. Update S3 guideline on irritable bowel syndrome: definition, pathophysiology, diagnosis and treatment. Joint guideline of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the German Society for Neurogastroenterology and Motility (DGNM) – June 2021 – AWMF registration number: 021/016. Z Gastroenterol. 2021 Dec;59(12):1323-1415.
- Riedl A, Schmidtmann M, Stengel A, Goebel M, Wisser AS, Klapp BF, Mönnikes H. Somatic comorbidities of irritable bowel syndrome: a systematic analysis. J Psychosom Res. 2008 Jun;64(6):573-82. doi: 10.1016/j.jpsychores.2008.02.021. Epub 28 April 2008. PMID: 18501257.