Functional GI Disorders: A Psychiatric Perspective

At first glance, it would seem peculiar to be discussing GI disorders in a psychiatric publication. However, functional GI disorders (FGIDs) represent a unique subset of GI disorders that have strong psychiatric implications beyond mere psychiatric comorbidity and/or psychosocial distress, which are indeed frequent concomitants of these disorders. There is increasing evidence that psychopharmacologic and psychotherapeutic management of FGIDs are highly effective and, in many instances, surpass the efficacy of standard medical treatment. This article reviews the diagnostic criteria for FGIDs and briefly discusses their presentation and medical evaluation. The role of the psychiatrist in treating patients with these disorders is discussed in greater detail, with an emphasis on psychopharmacologic treatment. In addition, the emerging and quite exciting literature supporting the role of psychotherapy and other behavioral interventions in managing these complex disorders and their psychosocial concomitants, including psychiatric comorbidity, will be discussed.