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Patient-Specific Stress–Abdominal Pain Interaction in Irritable Bowel Syndrome: An Exploratory Experience Sampling Method Study


Lisa Vork

Daniel Keszthelyi

Sander M.J. van Kuijk

Emilio G. Quetglas



Qasim Aziz

Jan Tack

Zlatan Mujagic

Carsten Leue

Joanna W. Kruimel

Ad A.M. Masclee



Gastrointestinal symptoms in irritable bowel syndrome (IBS) have been correlated with psychological factors using retrospective symptom assessment. However, real-time symptom assessment might reveal the interplay between abdominal and affective symptoms more reliably in a longitudinal perspective. The aim was to evaluate the association between stress and abdominal pain, using the Experience Sampling Method (ESM) as a real-time, repeated measurement method.


Thirty-seven patients with IBS (26 women; mean age 36.7 years) and 36 healthy controls (HC; 24 women; mean age 31.1 years) completed an electronic ESM during 7 consecutive days. Abdominal pain and stress were scored on an 11-point Numeric Rating Scale at a maximum of 10 random moments each day.


Abdominal pain scores were 2.21 points higher in patients with IBS compared with those in HC (P < 0.001), whereas stress levels did not differ significantly (B: 0.250, P = 0.406). In IBS, a 1-point increase in stress was associated with, on average, 0.10 points increase in abdominal pain (P = 0.017). In HC, this was only 0.02 (P = 0.002). Stress levels at t = ?1 were not a significant predictor for abdominal pain at t = 0 in both groups, and vice versa.


Our results demonstrate a positive association between real-time stress and abdominal pain scores and indicate a difference in response to stress and not a difference in experienced stress per se. Furthermore, an in-the-moment rather than a longitudinal association is suggested. This study underlines the importance of considering the individual flow of daily life and supports the use of real-time measurement when interpreting potential influencers of abdominal symptoms in IBS.


Vork, L., Keszthelyi, D., van Kuijk, S. M., Quetglas, E. G., Törnblom, H., Simrén, M., …Masclee, A. A. (2020). Patient-Specific Stress–Abdominal Pain Interaction in Irritable Bowel Syndrome: An Exploratory Experience Sampling Method Study. Clinical and Translational Gastroenterology, 11(7), Article e00209.

Journal Article Type Article
Acceptance Date Jun 18, 2020
Publication Date Jul 1, 2020
Deposit Date Aug 18, 2020
Publicly Available Date Aug 20, 2020
Journal Clinical and Translational Gastroenterology
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 11
Issue 7
Article Number e00209
Keywords Gastroenterology
Public URL
Publisher URL


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