Identification of psychological factors in refractory functional gastrointestinal disorders / 中国实用内科杂志

ABSTRACT

Functional gastrointestinal diseases(FGIDs) mainly include functional dyspepsia (FD),irritable bowel syndrome (IBS),functional constipation (FC) and functional abdominal pain syndrome (FAPS).In gastroenterology outpatient,42%～61% FGIDs patients have psychological factors,mostly depression and anxiety.The personality of these patients are almost introvert.Negative life events can be an incentive to lead to depression and anxiety which can aggravate the functional gastrointestinal symptoms.Clinical manifestations include long-term abdominal discomfort,abdominal pain (some with no fixed position),abdominal distension,anorexia,change in bowel habits,retrosternal and upper abdominal burning pain or overlapping symptoms.Some have obvious emotional performance.Dyspepsia symptom score of FD patients with mental disorders are higher than those who have no emotional performance and the gastric emptying decrease greatly than the latter.FGIDs treated by systemic therapy but with no improvement in symptoms may have somatization,compulsion,interpersonal tension,depression,anxiety and other psychological disorders.So psychological evaluation should be carried out to make early recognition for refractory functional gastrointestinal disorders.