Inflammatory bowel disease (IBD) is a generic term used to describe a group of chronic and relapsing inflammatory disorders of the gastrointestinal tract, of which Crohn’s disease (CD) and ulcerative colitis (UC) are the most common. IBD is characterised by an inappropriate immune response that causes characteristic inflammatory lesions in the gut wall. The aetiology of IBD is unknown. Nonetheless, genetic, immune and environmental factors have all been implicated in its causation. Interestingly, stress has been found to lead to exacerbation of the disease.¹ IBD is at present an incurable condition and its course is unpredictable. As the disease is usually diagnosed in young adults, sufferers must often cope with their disease for many years. Their quality of life and psychosocial wellbeing may be profoundly impaired as a consequence of systemic symptoms, surgery (such as installing a stoma), medication side effects and highly prevalent fatigue.²

IBD is often associated with irritable bowel syndrome (IBS).³ Up to 60% of IBD patients in remission continue to suffer symptoms of IBS.⁴ For these patients, quality of life and psychosocial wellbeing remain impaired regardless of whether IBD is active or quiescent. Furthermore, in population-based studies more than 50% of IBS patients have reported psychiatric symptoms.⁵ Thus, anxiety and depression in patients with IBD may be partly explained by co-existent IBS. In view of the above findings, it is not surprising that the rate of anxiety and depression in patients with IBD is around 30% during remission6 and as much as 70% during relapse.⁷

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