Background: Inflammatory bowel disease (IBD) is a multi-factorial systemic disorder which involves
immune, genetic and environmental factors. Stress, in its various forms, plays an important role in gastrointestinal
diseases and, in particular, in IBD.
Methods: Here, we focus on the environmental stressors in different aspects of IBD (pathogenesis, course and
severity of disease) and, in particular, will evaluate the mechanisms by which they may influence IBD.
Results: The effect of stress on IBD might be mediated by autonomic nervous system and hypothalamic pituitary
adrenal axis. These nervous pathways are part of the so called “brain-gut axis” which links gastrointestinal integrity
and functions to central nervous system acting through the increase of intestinal permeability, bacterial translocation
and cytokines network.
Conclusion: The incidence of emotional disorders is higher in Crohn's Disease and Ulcerative Colitis compared
to general population. Moreover, depression and anxiety influence the course and the severity of the underlying
intestinal disease. Hence, it is important to consider appropriate psychological therapy in IBD patients.