The Relationship Between Interoception, ACEs, and Emotional Processes in IBD

Emerging evidence highlights the crucial role of interoception—the ability to perceive internal bodily sensations—in shaping psychological and somatic health. This narrative review explores the relationship between interoception and Adverse Childhood Experiences (ACEs), and its relevance in Inflammatory Bowel Diseases (IBDs), a group of chronic immune-mediated conditions. ACEs have been shown to compromise interoceptive development, contributing to emotional dysregulation, altered brain-body communication, and increased vulnerability to both mental and physical disorders. In patients with IBDs, interoceptive impairments manifest not only in physiological hypersensitivity to visceral stimuli but also in the subjective interpretation of these signals, often influenced by emotional distress and trauma history . These interoceptive dysfunctions are associated with structural and functional brain alterations, particularly in areas involved in emotional and bodily processing, such as the insular and somatosensory cortices. The review underscores the bidirectional communication along the gut-brain axis and its modulation by psychological factors, suggesting that interoceptive dysfunctions may serve as a key mechanism linking early trauma, emotional suffering, and chronic gastrointestinal symptoms. Integrating interoception-informed interventions in the treatment of IBDs could improve emotional regulation and enhance patients’ quality of life.