In addition to gastrointestinal symptoms, IBS patients often experience a wide range of other problems, such as non-abdominal pain, psychological symptoms, low quality of life, as well as difficulties in carrying out activities of daily life[13,20,21]. They also exhibit complicated body tensions, bodily stress patterns, low body awareness and abnormal stress parameters[18,22-27]. Many IBS patients have been exposed to traumatic events and may also have low self-esteem, difficulties setting limits and hypersensitivity[28,29]. Therefore IBS patients may show many signs of being in a state of chronic distress.

Throughout the literature, two views emerge; one is the medical view of IBS as a strict disease of the gastrointestinal tract, while the other is the psychosomatic/biopsychosocial view in which IBS is seen as a more complex multi-symptomatic disorder.

Substantial evidence exists that IBS shares many features with other syndromes such as fibromyalgia, chronic fatigue syndrome, somatoform disorders, and unexplained urological conditions[35,36]. The diagnosis given to a patient with one of these conditions often depends on the hallmark symptom and the expertise of the treating clinician rather than on the condition itself[32,35].

"When a person feels danger, the fight or flight response of the central nervous system is triggered. At the same time, the enteric nervous system's response is to slow down or stop digestion. This is done so that more of the body's energy can be diverted to the situation causing the threat."

"The fear of public speaking also causes the digestive system to either slow down or speed up depending on the GI disorder and can cause abdominal pain, diarrhea, and other symptoms. Emotions, feelings of excitement, or nervousness can cause the familiar churning in the stomach -- the so-called "butterflies in your stomach" feeling."

"There's actually a way to harness the placebo effect without lying to patients, though. You tell them it's a sugar pill. Patients with irritable bowel syndrome were randomized to either get nothing — or a prescription medicine bottle of placebo pills with a label clearly marked "Placebo pills," "Take 2 pills twice daily." I kid you not.

And lo and behold, it worked. That's how powerful the placebo effect can be for irritable bowel. They conclude that for some disorders, it may be appropriate for clinicians to recommend that patients try an inexpensive and safe placebo."

Note: Group 1 was given nothing. Group 2 was given pills which were clearly marked "Placebo Pills -- Take 2 pills twice daily!" Turns out Group 2 showed substantially more improvement with respect to IBS! See the chart above.

Psychotherapy alone can provide lasting benefits. In a study, 101 outpatients with irritable bowel syndrome were randomized to medical treatment or medical treatment with three months of psychotherapy. After three months, the psychotherapy group did better, and the difference was even more pronounced a year later—a year after the psychotherapy ended. Better at three months, and even better at 15 months.

Psychological approaches appear to work about as well as antidepressant drugs for IBS, but the placebo response for IBS is on the order of 40 percent, and that’s whether you’re talking about psychological interventions or drugs or alternative medicine approaches. So essentially nothing—a sugar pill—improves symptoms 40 percent of the time.