Lecture – Functional Gastrointestinal Disorders and Psychiatry

Available with English captions.

McLean Forum
Holly S. Peek, MD, MPH, McLean Hospital

Functional gastrointestinal disorders (FGIDs) are the most common referral to a gastroenterology clinic. They are characterized as disorders of gut-brain interaction and are currently classified and diagnosed using the Rome IV Criteria.

Previously, these disorders have been misunderstood and stigmatized based on the difficulty in pinpointing a source of organic disease. Additionally, FGIDs are commonly also diagnosed with psychiatric illnesses such as anxiety, depression, suicidality, and trauma.

For these reasons, patients with FGIDs are often referred to mental health clinics and can be particularly challenging given the level of distress and impact on quality of life.

The development and perpetuation of FGID symptoms can be best understood through a biopsychosocial model, including the gut-brain axis, which also helps to explain the intersection of these gastrointestinal disorders with psychiatry. The understanding of this model helps to inform how some of our psychiatric treatment approaches, including psychopharmacology and psychotherapies, can help provide relief from both gastrointestinal and mental health symptoms.

Presentation highlights include:

  • Identifying the diagnoses of functional gastrointestinal disorders (FGIDs).
  • Description of the biopsychosocial model of FGIDs, including the gut-brain axis, and how these models help to explain the development of these conditions as well as common co-occurring psychiatric disorders
  • Explanation of how psychopharmacologic and psychotherapeutic treatments can treat FGIDs while also addressing coexisting mental health diagnoses