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Functional Gastrointestinal Disorders: An Update for the Psychiatrist

Received February 27, 2006; revised May 8, 2006; accepted June 13, 2006. From the Feinberg School of Medicine, Northwestern University, Chicago, IL; Mayo Clinic College of Medicine, Scottsdale, AZ; Univ. of South Alabama, Mobile, AL; and Manchester Royal Infirmary, Manchester, UK. Send correspondence and reprint requests to Michael P. Jones, M.D., 251 East Huron St., Galter Pavilion 4-104, Chicago, IL 60611-2908. e-mail: mpjones{at}nmh.org

Functional gastrointestinal disorders (FGID) are common conditions, with well-established diagnostic criteria. They are associated with impaired health-related quality of life and increased societal and healthcare costs. Their symptoms are probably related to altered 5-HT transmission and central processing of noxious visceral stimuli. Evaluation and treatment are best formulated using a biopsychosocial model that integrates gut function with psychosocial assessment. Psychological therapies may improve overall well-being and appear to help patients without significant psychiatric comorbidity. Antidepressants help comorbid anxiety and depressive disorders and have primary efficacy in improving the symptoms of FGID. Finally, there is a need for greater involvement of psychiatrists in both the evaluation and treatment of patients with FGID as well as the education and training of practitioners caring for these patients.

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