RESEARCH ARTICLE More negative self-esteem s

is available at the end of the articleBackground Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disease, characterized by abdominal pain and disturbed bowel habits. The diagnosis is based on symptoms and exclusion of organic gastrointestinal dis-ease [1]. IBS affects approximately 10 % of the general population and the majority is diagnosed in primary care [2]. It is associated with impaired quality of life and in-creased use of health care resources [3-5]. The etiology of IBS remains unclear and so far no specific biological abnormality has been identified that would explain the symptoms, despite intense research efforts [6]. Currently the pathophysiology of IBS is viewed as being caused by a dysregulation of the brain-gut axis [7,8] meaning dis-turbances in the bi-directional communication between peripheral factors in the gut such as neuro-immune mechanisms [9], mucosal barrier function [10], micro