Psychosomatic aspects of bowel diseases

Functional gastrointestinal disorders (FGID) and inflammatory bowel diseases (IBD) are the most frequently studied bowel disorders in the context of a bio psycho-social model. FGID are associated with significant work absenteeism, impaired quality of life, and increased medical costs. Many patients also suffer from psychosocial problems. Most of the research in FGID to date has focused on the irritable bowel syndrome. Randomised controlled studies have shown that psychotherapy is superior to conventional medical therapy. The gut-focussed hypnotherapy seems to be very successful. For IBD it is increasingly recognized that the psycho-neuro-endocrine network can modulate inflammation and pain perception and that psychosocial factors are related to exacerbation of and coping with IBD. The psychosocial consequences of the illness become more significant with increasing severity of the disease. Therefore integrated psychosomatic care should be provided, the patient's psychosocial status and the demand for additional psychological care should be assessed and offered, if indicated.