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Bloating is a frequent complaint of women with irritable bowel syndrome (IBS). We compared retrospective and daily diary gastrointestinal and psychological distress symptoms in 183 women ages 18–48 in three IBS subgroups: Minimal‐Bloating, Mild‐Bloating, Moderate‐Severe‐Bloating. More women with moderate to severe levels of bloating reported a history of hard stools, straining to have a stool, a history of depressive disorders, and more severe daily symptoms of depression and anxiety as compared to women with minimal or mild bloating symptoms. Appraising the level of symptom severity and psychological distress is vital to the selection of appropriate treatment options. © 2008 Wiley Periodicals, Inc. Res Nurs Health 31:98–107, 2008