{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:05:22Z","timestamp":1787702722324,"version":"build-2784847793"},"reference-count":66,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Irritable bowel syndrome (IBS) is a heterogenous disorder of gut\u2010brain interaction, characterized by complex interaction between gastrointestinal symptoms, psychological distress and physical functioning. While physical activity is increasingly recommended as part of IBS management, the pathways through which physical and mental health relate to symptom severity remain incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the interrelationships between physical activity, physical health, mental health and IBS symptom severity using Structural Equation Modeling (SEM) within a biopsychosocial framework, in adults with IBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional exploratory study, 106 adults with a clinician\u2010confirmed diagnosis of IBS (Rome IV criteria) completed validated questionnaires assessing IBS severity (IBS\u2010SSS), physical activity (GPAQ), anxiety (GAD\u20107), depression (PHQ\u20108), and health\u2010related quality of life (SF\u201036). Bivariate correlations were examined, followed by SEM to investigate relationships between latent constructs of physical health and mental health on IBS symptom severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants (mean age: 45\u2009\u00b1\u200914\u2009years; 82% female) reported high IBS symptom severity (333\u2009\u00b1\u200989) and wide\u2010ranging physical activity levels (mean: 3382\u2009\u00b1\u20094482 MET\u2010min\/week). Bivariate analysis showed significant correlations between IBS symptom severity and anxiety (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.235,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), depression (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.240,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and multiple physical health domains, including pain (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.454,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the SEM physical health demonstrated a large but non\u2010significant association with IBS symptom severity (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.065), while mental health showed no statistically significant direct path (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.261). Physical activity was significantly associated with physical health (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and physical and mental health latent constructs were strongly correlated (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.72).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory SEM study physical and mental health were closely interrelated and associated with IBS symptom severity at the correlational level, although direct paths in the SEM did not reach conventional statistical significance. Physical activity was linked to physical health, suggesting a potential indirect pathway influence symptom severity. These findings support a biopsychosocial perspective and highlight the need for integrated, personalized IBS management approaches, while underscoring the important of larger, longitudinal studies to clarify causal pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70300","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T07:31:26Z","timestamp":1775115086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Physical and Mental Health as Biopsychosocial Correlates and Pathways Associated With Symptom Severity in Irritable Bowel Syndrome: A Cross\u2010Sectional Structural Equation Modeling Study"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7904-3962","authenticated-orcid":false,"given":"Hannah B.","family":"Lindsell","sequence":"first","affiliation":[{"name":"Department of Sport, Health and Performance Enhancement (SHAPE) Research Centre, Department of Sport Science Nottingham Trent University  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2957-4684","authenticated-orcid":false,"given":"Maura","family":"Corsetti","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust UK, School of Medicine  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Darie","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust UK, School of Medicine  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2554-3701","authenticated-orcid":false,"given":"Daniele","family":"Magistro","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Environmental and Life Sciences University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Mohanan","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust UK, School of Medicine  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma E.","family":"Walton","sequence":"additional","affiliation":[{"name":"Department of Food and Nutritional Sciences The University of Reading  Reading UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil C.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Sport, Health and Performance Enhancement (SHAPE) Research Centre, Department of Sport Science Nottingham Trent University  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.031"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.14592.1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876\u2010020\u201001593\u20105"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14574"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.2.131"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.027"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12385"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u2010277X.2011.01162.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.24875\/ngl.19000033"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2018.02.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102008\u20101038600"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2017.12.016"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002112"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102013\u2010306541"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/sports9020014"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000126"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2015.1011875"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fuaf037"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14989"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70004"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI76304"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.04.019"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16001"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph16101405"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406\u2010014\u20100502\u2010z"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl.2011.5.1.29"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15325"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13619"},{"key":"e_1_2_11_31_1","first-page":"126","article-title":"Physical Activity, Exercise, and Physical Fitness: Definitions and Distinctions for Health\u2010Related Research","volume":"100","author":"Caspersen C. 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