A significant proportion of the population (14%-22%) appears to have symptoms compatible with the irritable bowel syndrome, yet only a small number seek medical aid. To explore why some people with bowel dysfunction go to the doctor and others do not, we surveyed 566 healthy subjects. Eighty-six (15%) had bowel dysfunction compatible with irritable bowel syndrome, but the majority of those affected (53 subjects or 62%) had never been to a doctor for these complaints. Although those who consulted physicians for bowel symptoms were more likely to report abdominal pain than those who did not, pain was not sufficient to explain doctor visits. Subjects with bowel dysfunction also reported more nongastrointestinal symptoms, and those with bowel dysfunction who visited physicians were more likely to see physicians for their nongastrointestinal symptoms. The reported higher prevalence of psychopathology among the patient population with irritable bowel syndrome may be due to behavioral influences that lead to health care seeking.