**5.5 Inflammatory bowel disease: celiac disease and UC**

Stressors (i.e. environmental events) can affect the expression of symptoms in people with Crohn. It was suggested by Crohn himself, in his book Regional ileitisi in 1949 [250]. It has been reported that stressful life events cause the disease to manifest since 1960 [251–255]. UC has been shown to be psychosomatic disease since 1969 [256]. Psychological stress has been shown to promote systemic and mucosal proinflammatory responses, which could contribute to the exacerbation of UC in everyday life [257]. The UC patients exhibit hostility, somatization, anxiety, and depression even during remission, which is not surprising since the disease was entirely reversible [258]. In general, IBD exhibit more psychological disorder. IBD patients suffer

## *Autoimmune Diseases of the GI Tract Part I: Etiology and Pathophysiology DOI: http://dx.doi.org/10.5772/intechopen.106184*

from high rates of psychological distress and comorbid conditions, including depression, anxiety disorders, and bipolar disorder according to a cohort study [259]. An analysis of 1078 patients with IBD, including 303 patients with Crohn's disease and 775 patients with ulcerative colitis, found that 75% of patients believed that psychologic stress caused an exacerbation of their symptoms [260].
