What Shame Does To IBS, And How To Loosen Its Grip

August 16, 2026•7 min read

You left the dinner early. Not because you wanted to, but because the pain had arrived and the bathroom was through the kitchen where everybody was standing, and you could already hear yourself having to explain. So you said you had an early start. You put your coat on with a bright face and you said your goodbyes and you got out. Then you sat in the car for a minute before starting it, and underneath the relief there was something else, hot and small and familiar. Not pain this time. Something closer to embarrassment about being a person who has to leave.

That second feeling almost never gets talked about in a GP appointment. This week's research suggests it should be, because it may be doing more damage than anyone has measured before.

This week's research: the same symptoms, two very different lives

A team led by Inês Trindade at Örebro University in Sweden, working with researchers at the University of Gothenburg under Professor Magnus Simrén, published a study in the journal Gastroenterology looking at what shame does to people with bowel disorders of gut-brain interaction. Irritable Bowel Syndrome is the best known condition in that group.

More than 2,400 Swedish adults took part. Of those, 537 met the criteria for a bowel disorder of gut-brain interaction, and they were compared against 1,881 matched people with no bowel symptoms at all. Everyone filled in validated questionnaires covering shame, symptom severity, gut-specific anxiety, general anxiety, low mood, quality of life, and how much daily activity they were losing.

Two things came out of it. The first is unsurprising but worth having in print: the group with bowel symptoms carried noticeably more shame than the comparison group (average scores of 13.17 against 9.05 on the measure used). The second is the finding that makes this study the first of its kind. Shame was not just sitting alongside the symptoms. It was doing work. Statistically, shame turned out to be part of the pathway connecting bowel symptoms to anxiety, to low mood, to poorer quality of life, and to lost activity. It also acted as an amplifier: at the same level of physical symptoms, people carrying more shame reported significantly worse quality of life than people carrying less. Same guts, different life.

Why this matters for you. If you have ever suspected that IBS costs you more than the symptoms alone should account for, this is the first study to put a number on why. It is also a quiet vindication. The shame is not a personal weakness you have layered on top of a medical problem, it is a predictable response to a condition that society treats as embarrassing, and it is measurable. We looked at the other half of this picture, the physical evidence that IBS is real, in an earlier edition of Mind Your Guts. This study is the emotional half of the same argument. One caveat to hold: this was a snapshot in time rather than a trial, so it maps the relationships rather than proving which came first.

Why shame is a gut-brain problem, not just a feeling

Here is the part that connects to everything else we talk about here. Shame is not inert. It changes behaviour, and the behaviours it produces are exactly the ones that keep IBS going.

Shame makes you conceal. Concealing means monitoring, which means a constant background scan of your abdomen for the first sign of trouble, which is the definition of gut-specific vigilance. Shame also makes you avoid: the dinner, the long drive, the restaurant, the food you are not sure about. Every avoidance teaches your nervous system that the threat was real and that escape was the right answer, so the alarm is set a little more sensitively next time.

That matters because of how IBS actually works. Your gut and your brain are in constant two-way conversation along the gut-brain axis. In IBS, the volume on that conversation is turned up, so ordinary gut activity that another person would never notice gets amplified on the way to the brain and arrives as pain or urgency. That is visceral hypersensitivity, and it is a change in signal processing, not a change in character. Vigilance sharpens the signal. Anticipation sharpens it further. Shame keeps you doing both, all day, without ever naming what it is doing.

This is precisely the loop that gut-brain therapies are built to interrupt. The British Society of Gastroenterology gives gut-directed hypnotherapy a strong recommendation, and NICE lists it as an option for IBS that has not responded to first-line treatment after twelve months. In well-designed individual trials, gut-directed hypnotherapy has commonly produced response rates in the region of 70 to 80%, sustained at twelve-month follow-up. Those are trial findings rather than guideline claims, and they are worth knowing accurately.

The work I do is cognitive behavioural hypnotherapy, which brings CBT, mindfulness and gut-directed hypnotherapy together rather than choosing between them. CBT works on the thoughts and the avoidance. Mindfulness works on the monitoring. Gut-directed hypnotherapy works directly on the signal. Shame runs through all three, which is why it is worth addressing in the room rather than leaving it to sit underneath everything unspoken.

Your top tip this week

When the hot feeling arrives, name it as shame, then answer it the way you would answer a friend. The study points to compassion as the counterweight to shame, and most people with IBS receive very little of it, least of all from themselves. So the next time you leave early, cancel, or find yourself inventing a cover story, catch the feeling that follows and label it silently and precisely: that is shame, and it is a response to stigma, not a fact about me. Then give yourself thirty seconds of the sentence you would offer a friend in the same position, something plain like of course you left, you were in pain, and that was a sensible thing to do. Naming an emotion accurately takes some of the heat out of it, and answering it with warmth stops it recruiting you into another round of concealing and avoiding. This study did not test that exercise, so treat it as a sensible application of what it points to rather than a finding from it.

The takeaway

Two people can have the identical severity of IBS and be living two entirely different lives, and one of the things that separates them is how much shame they are carrying. That is hard to read and it is also the hopeful part, because shame is not fixed. It responds to being named, to being met with warmth, and to being taken seriously by someone who understands what is actually happening in your gut.

If you would like to talk about what a gut-brain approach might look like for your symptoms, that is a conversation I am always glad to have, with no obligation either way. Or simply keep reading Mind Your Guts each week and take whatever is useful.

About Mind Your Guts

Mind Your Guts is the Irritable Bowel Syndrome (IBS) blog written by Kathryn Dunn, a cognitive behavioural hypnotherapist based in York and working online. One piece of gut-brain research each week, in plain language, and one thing worth trying. More at mindyourguts.co.uk/gut-feelings.

Twelve Minutes of Calm. A free relaxation recording, about twelve minutes, for the times you want to feel calmer. It is a general relaxation recording rather than a treatment for anything. Download it at mindyourguts.co.uk/free-relaxation-page and you will also join Gut Feelings, my weekly email, which carries each new post to your inbox along with a bit extra.

Hypnotherapy works alongside conventional medical care, never in place of it. This blog shares research for general information and is not a substitute for medical advice. Always consult your GP or another relevant health professional. If your symptoms are new, changing, or accompanied by warning signs such as bleeding, unexplained weight loss, or persistent pain, please see your GP.