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Bowel Obsession Syndrome in a Patient With Ulcerative Colitis

Received December 12, 2006; accepted January 4, 2007. From the Psychosomatic Unit and Department of Gastroenterology, IRCCS De Bellis Hospital, Castellana Grotte, Italy. Send correspondence and reprint requests to Piero Porcelli, Ph.D., Unità di Psicosomatica, IRCCS Ospedale De Bellis Via della Resistenza, 70013 Castellana Grotte, Bari, Italy. e-mail: porcellip{at}media.it
© 2007 The Academy of Psychosomatic Medicine

Gastroenterologists are often faced with the diagnostic problem of differentiating acute symptoms of ulcerative colitis from functional intestinal disorders. Bowel obsession syndrome (BOS) is an OCD-like, functional syndrome characterized by fear of fecal incontinence and compulsive behaviors of evacuation-checking. Only sparse case studies on treatment of BOS with antidepressants have been published. This is the first study on successful psychotherapy of a male patient with ulcerative colitis overlapping functional bowel symptoms and marked symptoms of BOS. Clinical recognition of BOS may help clinicians in differential diagnosis, prevent unnecessary investigations, and give patients the most appropriate treatment.

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