Psychosocial factors, psychiatric illness and functional gastrointestinal disorders: a historical perspective.

A new classification of functional gastrointestinal disorders (FGID) became available recently, based on consensus in expert committees ('Rome III process'). It is widely accepted that these frequent disorders, although their pathophysiology remains incompletely understood, result from a complex reciprocal interaction between biological, psychological and social factors that can be predisposing, precipitating and/or perpetuating. Comorbidity with psychiatric disorders, especially mood and anxiety disorders, is high. Modern epidemiologic, psychophysiological and functional neuroimaging studies have partially elucidated the mechanisms underlying the relation between cognitive-affective processes on the one hand and GI function and symptom reporting on the other. The aim of this article is to provide a noncomprehensive historical review of the literature on FGID up to the mid-20th century, with special emphasis on the role of psychosocial factors and psychiatric comorbidity. We can conclude from this review that a lot of the knowledge that became available recently through modern research methodology can also be found in the historical psychosomatic and neuroscience literature, though obviously less empirically grounded. This provides further support for an integrative, multidisciplinary biopsychosocial approach to FGID.

[Historical viewpoint on the irritable bowel syndrome]. / Regards sur l'histoire de l'intestin irritable.

Contrary to common thought, the conception of the irritable bowel syndrome (IBS) is relatively old, even if the current term dates from as recently as 1944. Long ago, several ancient, and disparate terms, some of them corresponding to currently exceptional clinical pictures, were used. Does that mean that these banal complaints, currently of prime importance among the clinical signs in gastroenterology, were left aside in favor of more severe disease? Surely this is not the case because functional pain has always existed, the only problem is to know whether it was or could be recognized. It was Amboise Paré who first mentioned an ancestor to the IBS when he spoke of "windy colic" (Le Miroir de Beauté et de Santé Corporelle). The glorious kingdom of nervous, chemical, motor, buccal, and intestinal disorders predominated in Gastroenterology at the end of the nineteenth century and the two diseases suggesting functional intestinal problems, i.e. enteroptosis and chronic intestinal stasis, were relegated to second place. Mucomembraneous entercolitis represents one of the most illustrated and widely described offsprings. At the beginning of the twentieth century, progress in roentgenology has allowed to dismember the category of colitis and distinguish between functional and organic diseases. Of the many terms used, "nervous colic" and "irritable intestine" are two which suggest the pathophysiological duality of the disease. Further development of studies on colonic and intestinal motility should allow to identify the authentic motor disorders, even though some etiologies may still go recognized...