Lower levels of physical and psychological coping skills are associated with increased gastrointestinal and extraintestinal somatic symptom severity in patients with irritable bowel syndrome (IBS), according to data published in Clinical Gastroenterology and Hepatology. The association is partially mediated by levels of anxiety and depressive symptoms.

Researchers from the University of Gothenburg in Sweden conducted a cross-sectional study of 216 IBS patients to assess the relationship between coping resources and gastrointestinal symptom severity and sought to identify potential mediators of this relationship. Participants attended a secondary care specialized outpatient center in Sweden between 2003 and 2007. They completed a validated self-report questionnaire to assess coping resources, levels of anxiety, depressive symptoms, levels of gastrointestinal symptoms, and extraintestinal somatic symptoms.

The results showed that better physical coping, including physical exercise and eating healthy foods, was associated with lower levels of gastrointestinal symptom severity (P<.0001), while lower levels of psychological (P=.0004) and physical coping resources (P<.0001) were associated with more severe somatization.

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The effects of physical coping resources on gastrointestinal symptom severity were partially mediated by levels of general anxiety (P=.017) and gastrointestinal-specific anxiety (P=.008). In addition, the effect of psychological coping resources on somatization was fully mediated by levels of anxiety (P=.0001) and depressive symptoms (P<.0001), and partially mediated by levels of gastrointestinal-specific anxiety symptoms (P=.006). The effect of physical coping resources on somatization was partially mediated by levels of anxiety (P=.012), depressive symptoms (P=.0008), and gastrointestinal-specific anxiety (P=.013).

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“Our results identify coping resources as a relevant factor associated with [gastrointestinal] and extraintestinal symptom severity in IBS,” the authors concluded. “Both components of the mediational pathway, impaired coping and anxiety and depression levels, may thus serve as potential targets for improving somatic symptoms in IBS. However, the effect of physical coping is only partially mediated through psychological symptom levels; therefore, it may be useful to target both physical coping mechanisms and psychological symptoms to improve somatic symptom severity in IBS.”


Wilpart K, Tornblom H, Svedlund J, Tack JF, Simren M, Van Oudenhove L. Coping skills are associated with gastrointestinal symptom severity and somatization in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol. 2017;15:1565-1571.