The role of emotional and psychological development in IBD has become increasingly relegated to the role of symptom rather than cause. Many sufferers and practitioners are reluctant to raise the issue since there is a feeling that looking for psychological factors as a possible cause is somehow placing the blame squarely on the victim. Yet we know that there is complex relationship between emotional and physical symptoms which remains frustrating to both patient and practitioner (Med Clin N Am, 1994; 78: 6). At the very least, paying attention to the way the patient adapts to the illness can help ease the symptoms of the disease.

Anxiety and depression are common in patients with abdominal symptoms (Can J Psychi, 1993; 38: 475-9).Neuropsychiatric complications are evident in at least a third of Crohn's sufferers, and more than half of these are thought to be the direct result of the disease. These can include headache, depression and eye problems (South Med J, 1997; 90: 606-10). Some Crohn's sufferers are given tranquillizers as a matter of course, the use of which brings their own unwanted side effects. Though few conventional practitioners are equipped to work in this way, talking cures and effective stress management could be a more effective way of dealing with the emotional fallout of IBD.