Functional Gastrointestinal Disorders - Role of Psychology
Functional gastrointestinal disorders (FGIDs) represent a unique subset of GI disorders that have strong psychiatric implications.
Quite exciting literature supporting the role of psychotherapy and other behavioral interventions in managing these complex disorders and their psychosocial concomitants, including psychiatric comorbidity is developing.
FGIDs consist of a wide spectrum of syndromes, which cross over and, in some cases, overlap various anatomic areas of the luminal gut. Although irritable bowel syndrome (IBS) has traditionally been the most studied and written about, FGIDs constitute a number of unique disorders, including functional esophageal disorders (noncardiac chest pain, functional dysphagia, and globus sensation); functional dyspepsia (pain, discomfort, nausea, and other symptoms above the navel in persons who do not meet the diagnostic criteria for IBS); functional abdominal pain syndrome; functional abdominal bloating; functional diarrhea; functional disorders of the biliary tract, including Oddi sphincter; functional disorders of the anorectal area, such as pelvic floor dyssynergia; and proctalgia fugax. Functional disorders are somewhat unique in gastroenterologic practice because they are diagnosed using symptom-based criteria.
Research has shown that even a relatively mild experimental stressor, like the frustrating experience of listening to two different types of music simultaneously, can increase sensitivity to visceral sensations in IBS patients and sensitivity to acid exposure in patients with gastroesophageal reflux disease (GERD). We and others have also shown that major stressors are associated with increased symptoms over the next few months in patients with IBS and GERD. Thus, stress can significantly increase symptoms (Naliboff).
Naliboff, Bruce D. , Symptom Based Psychology for Functional Gastrointestinal Disorders, http://www.giresearch.org/site/gi-research/iffgd-research-awards/2007/symptom-psychology