Best Practice Update: Incorporating Psycho-gastroenterology into Management of Digestive Disorders

Keefer L1, Palsson OS2, Pandolfino JE3. Gastroenterology. 2018 Jan 31. pii: S0016-5085(18)30113-6. doi: 10.1053/j.gastro.2018.01.045. [Epub ahead of print]

Author information

1 Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: laurie.keefer@mssm.edu.

2 University of North Carolina Chapel Hill, NC.

3 Northwestern University Feinberg School of Medicine, Chicago, IL.


Chronic digestive diseases including irritable bowel syndrome, gastroesophageal reflux disease and inflammatory bowel diseases cannot be disentangled from their psychological context-the substantial burden of these diseases is co-determined by symptom and disease severity and the ability of patients to cope with their symptoms without significant interruption to daily life. The growing field of psychogastroenterology focuses on the application of scientifically-based psychological principles and techniques to the alleviation of digestive symptoms. In this clinical practice update we describe the structure and efficacy of two major classes of psychotherapy-cognitive behavior therapy and gut-directed hypnotherapy. We focus on the impact of these brain-gut psychotherapies on GI symptoms as well as their ability to facilitate improved coping, resilience and self-regulation. The importance of the gastroenterologist in the promotion of integrated psychological care cannot be understated and recommendations are provided on how to address psychological issues and make an effective referral for brain-gut psychotherapy in routine practice.

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