A multinational study published in Clinical Gastroenterology and Hepatology found that abdominal pain in irritable bowel syndrome (IBS) is closely associated with daily-life factors, including emotional state, eating, and perceived environmental comfort. The study included 360 adults with Rome IV–defined IBS across seven European countries. Participants used a smartphone app to report symptoms and potential triggers 10 times daily over seven days.
Higher positive affect and greater environmental comfort were associated with lower abdominal pain, while negative affect and eating were associated with increased pain. However, most associations weakened substantially after researchers adjusted for disease severity, anxiety, depression, fatigue, and other somatic symptoms. Predictive associations between triggers and subsequent pain were relatively infrequent and modest, suggesting that many factors occur alongside pain rather than consistently preceding it.