News from the AGA

Psychotherapy helps patients with chronic digestive disorders


 

Patients with chronic digestive disorders can better cope with their symptoms and the effects on their daily lives when they receive support from mental health professionals specializing in psychogastroenterology, according to a new AGA Clinical Practice Update, published in the April issue of Gastroenterology (gastrojournal.org). Gastroenterologists who integrate brain-gut psychotherapies, including cognitive-behavior therapy (CBT) and gut-directed hypnotherapy, into their practice can help patients better understand and manage any psychiatric comorbidities and coping skills, which will help reduce patient symptom burden and health care resource utilization. These therapies are optimally delivered by mental health professionals specializing in psychogastroenterology, a field dedicated to applying effective psychological techniques to GI problems.

According to best practice advice, to help promote the use of brain-gut psychotherapies in routine GI care, gastroenterologists should:

1. Routinely assess health-related quality of life, symptom-specific anxieties, early life adversity and functional impairment related to a patient’s digestive symptoms.

2. Master patient-friendly language on the following topics: the brain–gut pathway and how this pathway can become dysregulated by any number of factors; the psychosocial risk, perpetuating and maintaining factors of GI diseases; and why the gastroenterologist is referring a patient to a mental health provider.

3. Know the structure and core features of the most effective brain–gut psychotherapies.

4. Establish a direct referral and ongoing communication pathway with one to two qualified mental health providers and assure patients that he or she will remain part of their care team.

5. Familiarize themselves with one or two neuromodulators that can be used to augment behavioral therapies when necessary.

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