Interoceptive Sensitivity, Emotional Empathy, and Alexithymia in Irritable Bowel Syndrome: A Research Protocol

Abstract

The brain and gut are deeply interconnected both anatomically and functionally. Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder characterized by changes in bowel movements and chronic intestinal pain. Despite IBS being associated with increased interoceptive sensitivity and emotional distress, the relationship between IBS and empathy is not fully understood. This study aims to investigate whether individuals with IBS exhibit differences in emotional empathy and emotional processing compared to individuals without IBS, and whether heightened empathy exacerbates IBS symptoms through increased sensitivity to both internal gastrointestinal signals and external emotional cues. Participants will complete a behavioural empathy task involving emotionally salient film clips depicting social interactions. They will report their own emotional experiences and infer those of the characters, while physiological responses and eye tracking data are recorded. Self-report measures of empathy and interoceptive awareness will also be administered. Group differences and associations between empathy, interoceptive awareness, and symptom severity will be examined using appropriate statistical analyses.It is expected that individuals with IBS will demonstrate heightened emotional empathy and reactivity compared to controls, with stronger associations between interoceptive awareness and empathic distress.Predicted findings would support a bidirectional relationship between IBS and empathy, whereby IBS-related bodily sensitivity amplifies emotional attunement, and increased empathy worsens gastrointestinal symptoms. Conversely, a lack of association would suggest distinct processing mechanisms for empathy and direct emotional experience. This study seeks to advance an integrated model of IBS as a digestive disorder with significant affective and neurological dimensions. Results may inform future research on emotion-based intervention aimed at reducing both empathic distress and gastrointestinal symptoms, contributing to more holistic treatment approaches.