The Invisible Link Between Mind and Gut: The Effect of Alexithymia and Adjustment to Illness on Symptom Severity in IBS Patients With Rome IV Criteria.

Abstract

Background: Irritable bowel syndrome (IBS) is a gut-brain interaction disorder that significantly impacts quality of life, with symptoms influenced by stress, anxiety, dietary habits, and gut microbiota imbalances. Alexithymia, characterized by difficulties in identifying and expressing emotions, may exacerbate IBS symptoms by impairing stress management and illness perception. Additionally, poor adaptation to chronic illness can increase psychological burden and worsen symptom severity.

Methods: This cross-sectional study examined 148 IBS patients diagnosed using Rome IV criteria at a gastroenterology outpatient clinic. Data were collected through validated scales, including the IBS Symptom Severity Score (IBS-SSS), Twenty-Item Toronto Alexithymia Scale (TAS-20), and Chronic Disease Adaptation Assessment Scale (CDAAS). Correlation and multiple regression analyses were conducted to identify key predictors of symptom severity.

Results: IBS severity was notably high (mean IBS-SSS = 380.1 ± 61.5), with low income (B = 32.337, p = 0.002) and high alexithymia levels (B = 0.991, p = 0.045) emerging as strong predictors of increased symptom burden. Marital status also showed a notable association (B = 22.005, p = 0.085). While overall disease adaptation (CDAAS) was not directly linked to symptom severity, poor physiological adaptation correlated negatively with IBS symptoms, suggesting a critical role in disease perception. A significant inverse relationship was found between meal frequency and symptom severity (r = -0.170, p = 0.039), highlighting the impact of dietary habits on symptom control. The regression model explained 14.9% of variance (adjusted R² = 0.081).

Conclusion: IBS symptom severity is partially influenced by socioeconomic status, emotional regulation, and dietary patterns. These findings underscore the need for a multidisciplinary treatment approach integrating dietary modifications, psychological interventions, and tailored patient support to enhance disease management and improve patient outcomes.