Functional Gastrointestinal Disorders: An Anthropological Perspective

Fortin, Sylvie; Gómez, Liliana Paola Muñoz; Gauthier, Annie

doi:10.1007/978-1-60761-709-9_7

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…Nevertheless, there is an emerging consensus that a biopsychosocial approach to FGIDs may prove to be fruitful in understanding the illness‐related phenomena at the biological, psychological and social levels (Fortin et al . ). However, the cultural factors related to the evolution of FGIDs have received little attention and remain unclear in the scientific literature (Howell et al .…”

Section: Pathways To Care For Fgids: When and Why Do Families Seek Help?mentioning

confidence: 97%

Diverse pathways to care for children with stomach pain in a Canadian cosmopolitan city

Fortin

Gauthier

Gómez

et al. 2014

Health Soc Care Community

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In Montreal, Quebec, 31% of the population is born outside Canada. Yet, only 9% of patient consultations for symptoms associated with functional gastrointestinal disorders (FGIDs) are from immigrants at the Paediatric Gastroenterology Clinic at Sainte-Justine's University Hospital Centre. This discrepancy inspired a multidisciplinary exploratory study (anthropological and paediatric) to examine the sociological, interpretative and pragmatic aspects of immigrant and non-immigrant patients and family life with FGIDs. This paper examines the discrepancy between immigrant and non-immigrant paediatric patients with FGIDs and presents the different pathways to care utilised by families. Semi-structured interviews were carried out between November 2008 and June 2009, with children and their parents. In total, 38 families were recruited: with 27 families (including a child experiencing abdominal pain, his/her siblings, mother and/or father as well as any other significant individual living in the family home) from the community and 11 from the paediatric gastroenterology clinic. A comparative analysis between the immigrant and non-immigrant groups focused on perceptions, meanings and actions taken to relieve/alleviate symptoms. Immigrant and non-immigrant families alternate and combine different therapeutic environments: home, alternative healing therapies and medical paths to care. Our analysis suggests that culture (as a set of values, beliefs and ways of being), as well as social interactions within family life and the clinic, shape pathways to care. The analysis highlights the centrality of receptiveness--and more widely the social dimensions--of all medical encounters. Treatment disparities between immigrant and non-immigrant families in pathways to care help us to understand these patients' social world and the intricate relationships between values and social milieux, between culture, practices of symptom management and rationales guiding diverse therapeutic actions.

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Section: Pathways To Care For Fgids: When and Why Do Families Seek Help?mentioning

confidence: 97%

Diverse pathways to care for children with stomach pain in a Canadian cosmopolitan city

Fortin

Gauthier

Gómez

et al. 2014

Health Soc Care Community

Self Cite

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“…Even though 31% of the population is born abroad, only a small percentage (9%) of patients of a paediatric gastroenterology hospital clinic seeking consultations for symptoms associated with FGDs are migrants (Caplan, Walker and Rasquin, 2005). The prevalence rates of FGDs are 13-20% in the general Canadian population, 10-15% in the global population, and approximately 10% in the paediatric population (Fortin, Gomez and Gauthier, 2013). So….…”

Section: Diagnóstico Incierto E Itinerarios Terapéuticos De Niños De mentioning

confidence: 99%

“…The generally accepted hypothesis to explain the pain is that there is a combination of sensory and motor activity along the brain-gut axis. It appears that the information we get from the outside through our senses and perceptions (emotions, thoughts, smells, sights), by the nature of the neural connections in the higher centers, can affect gastrointestinal sensations(Fortin, Gomez and Gauthier 2013). In other words, stressful situations or…”

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confidence: 99%

Diagnostic fluidity: working with uncertainty and mutability

Nissen¹,

Risør

2018

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The multiplication of diagnoses, the seepage of diagnostic language into popular culture and the media, the rise of self-diagnosis and the world wide web, all position diagnosis as an important social phenomenon to which anthropology, sociology, and their cognate disciplines must pay particular attention. In order to understand the health goals to which individuals and communities aspire, it is important to know the place that diagnosis plays in understanding health and illness. In order to determine what conditions are of particular public concern, it is also vital to know how those conditions are conceptualised, categorised, and indeed, diagnosed. Whether it is fibromyalgia, gout, or obesity, each diagnosis is testimony to a particular way of seeing the world and understanding disease. Fibromyalgia, for example, is, as I write these words, a symptom-based diagnosis, established in the presence of a certain number of symptoms assembled in indicative ways. But, at the same time, it is a diagnosis which lacks legitimacy in the eyes of many, for the absence of biological markers providing so-called objective confirmation. This is why clinical researchers, and notably geneticists, are frenetically trying to discern a profile, be it genetic or biologic, which can explain this baffling condition. Gout is also determinant, but in other ways. It has biological markers, so its existence is not in doubt, but its causes and location raise questions. Does the problem of uric acid build-up in the joints belong to rheumatology, endocrinology or nephrology? Is it a disease of decadence, or one of poverty? Obesity, on the other hand, says much about who we are, and what a society should look like. In the neo-liberal context of responsibilisation, obesity, like gout, makes social statements about the large body, stigmatising at the same time as it rings alarm bells about the society in which the large individual is situated. The health of a nation is measured in BMI, with rising obesity touted as an alarming trend.

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Uncertainty, culture and pathways to care in paediatric functional gastrointestinal disorders

Fortin

Gauthier

Gómez

et al. 2013

Anthropology & Medicine

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This paper examines how children and families of diverse ethnic backgrounds perceive, understand and treat symptoms related to functional gastrointestinal disorders (FGIDs). It is questioned how different ways of dealing with medical uncertainty (symptoms, diagnosis) may influence treatment pathways. Semi-structured interviews were conducted with 43 children of 38 family groups of immigrant and non-immigrant backgrounds. The analysis takes into account (a) the perceived symptoms; (b) the meaning attributed to them; and (c) the actions taken to relieve them. The social and cultural contexts that permeate these symptoms, meanings and actions were also examined. It is found that, in light of diagnostic and therapeutic uncertainty, non-immigrant families are more likely to consult health professionals. Immigrant families more readily rely upon home remedies, family support and, for some, religious beliefs to temper the uncertainty linked to abdominal pain. Furthermore, non-immigrant children lead a greater quest for legitimacy of their pain at home while most immigrant families place stomach aches in the range of normality. Intracultural variations nuance these findings, as well as family dynamics. It is concluded that different courses of action and family dynamics reveal that uncertainty is dealt with in multiple ways. Family support, the network, and trust in a child's expression of distress are key elements in order to tolerate uncertainty. Lastly, the medical encounter is described as a space permeated with relational uncertainty given the different registers of expression inherent within a cosmopolitan milieu. Narrative practices being an essential dynamic of this encounter, it is questioned whether families' voices are equally heard in these clinical spaces.

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Functional Gastrointestinal Disorders: An Anthropological Perspective

Cited by 3 publications

References 27 publications

Diverse pathways to care for children with stomach pain in a Canadian cosmopolitan city

Diverse pathways to care for children with stomach pain in a Canadian cosmopolitan city

Diagnostic fluidity: working with uncertainty and mutability

Uncertainty, culture and pathways to care in paediatric functional gastrointestinal disorders

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