A new study of 148 people with IBS found that struggling to understand and express your emotions—a trait called alexithymia—may make gut symptoms more severe. Researchers also discovered that people with lower incomes and those who eat fewer meals per day tend to have worse IBS symptoms. The study suggests that treating IBS effectively requires more than just medication: it needs to address emotional health, eating patterns, and how well people adapt to living with a chronic condition. This research highlights why doctors should consider the mind-gut connection when helping IBS patients feel better.

The Quick Take

  • What they studied: Whether difficulty recognizing and expressing emotions, along with how well people adjust to having IBS, affects how severe their symptoms become
  • Who participated: 148 adults diagnosed with IBS using standard medical criteria, recruited from a gastroenterology clinic
  • Key finding: People who struggle to identify their emotions had worse IBS symptoms, and those with lower incomes also experienced more severe symptoms. Eating more frequent meals appeared to help reduce symptom severity.
  • What it means for you: If you have IBS, paying attention to your emotional health and eating regular meals might help manage your symptoms better. However, this study shows a connection, not proof that emotions cause IBS—more research is needed to confirm these relationships.

The Research Details

This was a cross-sectional study, which means researchers collected information from 148 IBS patients at one point in time rather than following them over months or years. Participants completed three validated questionnaires: one measuring IBS symptom severity, one assessing difficulty with emotions (alexithymia), and one evaluating how well they’ve adapted to living with their chronic illness. The researchers then used statistical analysis to identify which factors most strongly predicted worse IBS symptoms.

The study took place at a gastroenterology outpatient clinic, where patients were diagnosed using Rome IV criteria—the current gold standard for IBS diagnosis. All participants completed the questionnaires, and researchers analyzed the data to find patterns and relationships between emotional regulation, disease adaptation, and symptom severity.

This approach is important because it examines the mind-gut connection in real IBS patients using established diagnostic criteria and validated measurement tools. By looking at multiple factors simultaneously—emotions, adaptation to illness, income, and eating habits—the study provides a more complete picture of what influences IBS severity than looking at just one factor alone.

The study used well-established, scientifically validated questionnaires that have been tested in many previous studies. The sample size of 148 patients is reasonable for this type of research. However, the study only explains about 15% of why symptoms vary between people, meaning other important factors weren’t measured. Also, because this is a snapshot study rather than following people over time, we can’t determine whether emotions cause worse symptoms or if worse symptoms cause emotional difficulties.

What the Results Show

The study found that IBS patients in this group had notably high symptom severity on average. Two factors emerged as strong predictors of worse symptoms: having lower income and having higher levels of alexithymia (difficulty identifying and expressing emotions). For every unit increase in alexithymia scores, IBS symptom severity increased by about 1 point on the measurement scale.

Interestingly, marital status also showed a relationship with symptom severity, though this finding was borderline statistically significant. People’s overall ability to adapt to having a chronic disease wasn’t directly linked to symptom severity, but how well they adapted physically (managing the body’s responses) did show a connection.

One surprising finding was that meal frequency mattered: people who ate more frequent meals tended to have less severe symptoms. This suggests that eating pattern changes might be an important part of managing IBS.

While overall disease adaptation wasn’t directly related to symptom severity, physiological adaptation—how well people’s bodies adjusted to the illness—showed an inverse relationship with symptoms. This suggests that helping patients understand and manage their body’s physical responses to IBS may be important. The study also highlighted that socioeconomic factors (income level) play a significant role in symptom severity, which may reflect differences in access to healthcare, stress levels, or dietary quality.

This research aligns with existing studies showing that the gut-brain connection is real and important in IBS. Previous research has established that stress and anxiety worsen IBS symptoms, and this study extends that by showing that difficulty recognizing emotions may be an additional emotional factor. The finding about meal frequency supports dietary recommendations that have been suggested in other IBS research. However, the relatively small amount of variance explained (15%) suggests that many other factors beyond those measured also influence IBS severity.

This study has several important limitations. First, it’s a snapshot in time, so we can’t determine cause and effect—we know emotions and symptoms are related, but not which causes which. Second, the study only measured 148 people from one clinic, which may not represent all IBS patients. Third, the statistical model only explained about 15% of symptom severity variation, meaning 85% is influenced by factors not measured in this study. Fourth, the study didn’t measure actual dietary intake in detail, only meal frequency. Finally, there’s no control group without IBS for comparison.

The Bottom Line

If you have IBS, consider: (1) Working with a mental health professional on emotional awareness and stress management—this may help reduce symptom severity; (2) Eating regular, frequent meals rather than skipping meals; (3) Seeking a multidisciplinary treatment approach that includes dietary advice, psychological support, and medical care. These recommendations are supported by this research but should be discussed with your healthcare provider. Confidence level: Moderate—this study shows associations but not definitive proof.

This research is most relevant for people with diagnosed IBS who want to understand all factors affecting their symptoms. It’s particularly important for those struggling with emotional regulation or experiencing high stress. Healthcare providers treating IBS should consider this information when developing treatment plans. People without IBS don’t need to apply these findings, though the mind-gut connection may be relevant to general digestive health.

Changes in eating patterns might show effects within days to weeks. Improvements from emotional regulation work typically take longer—usually several weeks to months of consistent effort to see meaningful changes in symptom severity.

Want to Apply This Research?

  • Track meal frequency (number of eating occasions per day) alongside IBS symptom severity using a daily log. Record what time you eat and rate your symptoms on a 0-10 scale. Look for patterns between eating frequency and symptom flare-ups over 2-4 weeks.
  • Implement a regular eating schedule with 4-5 eating occasions per day (meals plus snacks) rather than skipping meals or eating irregularly. Use app reminders to eat at consistent times and log each eating occasion with symptom ratings to see if more frequent eating improves your symptoms.
  • Create a weekly dashboard showing: (1) Average meal frequency per day, (2) Average symptom severity rating, (3) Emotional stress level (simple 1-10 scale), (4) Any patterns between these three factors. Review monthly trends to identify what eating and emotional patterns correlate with your best symptom control days.

This research describes associations between emotional factors and IBS symptoms but does not prove that emotions cause IBS. IBS is a complex condition with multiple contributing factors. This information should not replace professional medical advice. If you have IBS or suspect you do, consult with a healthcare provider for proper diagnosis and treatment. Anyone considering psychological interventions should work with qualified mental health professionals. The findings apply specifically to the study population and may not generalize to all IBS patients.