Psychosocial Aspects of the Functional Gastrointestinal Disorders

Abstract

The functional gastrointestinal disorders (FGID) are the most frequent conditions seen in gastroenterology practice and comprise a major portion of primary care. Psychosocial factors are important in these disorders with regard to: (1) their eVects on gut physiology; (2) their modulation of the symptom experience; (3) their influence on illness behavior; (4) their impact on outcome; and (5) the choice of the therapeutic approach. This paper provides a review and consensus of the existing literature by gastroenterologists, psychiatrists, psychologists, physiologists, and health services investigators. Evidence is provided to support the biopsychosocial model as a basis for understanding and treating these disorders, and epidemiological and clinical information on the relations of psychosocial factors to gut physiology, symptom presentation, health behavior, and outcome is oVered. Features of motility, personality, abuse history, health concerns, and treatment-seeking diVer between patients with FGID and healthy controls, but they are not specific to FGID. They occur in other patients with chronic medical conditions and/or psychiatric disorders. Review of treatment trials indicates clear support for psychotherapeutic treatments, especially in the long term, as well as some evidence for the benefit of antidepressants in FGID, even in the absence of improvements in mood. (Gut 1999;45(Suppl II):II25-II30)

Frequency of Different Psychiatric Disorders in Patients With Functional Bowel Disorders: A Short Report

“…There are reports of high prevalence of psychiatric disorders (40% -60%) among patients with functional GI disorders including IBS (20). Even children and adolescents with functional abdominal pain syndrome have psychiatric illnesses more frequently compared with normal subjects and patients with organic GI diseases (2).…”

“…This could be explained by several theories. Both spectrums of disorders may have some pathophysiologic bases in common (19)(20)(21). The chronic nature of functional GI disorders may predispose patients to more psychiatric illnesses.…”

[No Title Available]

“…Dependendo do nível de confiança alcançado, pode ser apropriado explorar as zonas mais sensíveis como por exemplo, abuso na infância. Tratamento com antidepressivos geralmente melhora os sintomas do pacientes, reduz o sofrimento psicológico e melhora o bem estar e hábitos diários (16) . Em casos graves ou intratáveis, deve-se também considerar encaminhamento para profissional de saúde mental para ajudar o paciente a desenvolver estratégias eficazes de tratamento.…”

Hypnosis and upper digestive function and disease

“…This dissociation of sensory and affective components of pain under hypnosis would also be consistent with the new "dissociation theory" to explain the effectiveness of hypnotherapy in psychopathology [1,8,66] . There is growing evidence that patients with IBS, functional chest pain and probably functional dyspepsia show increased levels of vigilance toward gut pain related sensations, easily interpreting them as symptoms of disease as a consequence [62,67,68] . Modulating the affective component of pain ratings may be one of the therapeutic mechanisms of hypnotherapy in functional bowel disease.…”