Gastrointestinal disorders/psychosocial factors

Townsend Letter for Doctors and Patients,  July, 2004  by Robert A. Anderson

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It is widely accepted based on volunteer studies, that levels of psychological distress are similar in those with functional gastrointestinal (GI) disorders and those in good health, while increased psychological distress in outpatients is largely explained by health-care seeking. A case-control study recruited 103 subjects with functional GI disorders (irritable bowel syndrome and nonulcer dyspepsia) and 119 controls age 20-50. Functional GI disorders were more likely to be reported by those with higher scores on each of the nine SCL-90-R (Symptom CheckList) scales used to measure psychological distress (except phobic anxiety), as well as in those with more negative and total life event stress. Somatization, interpersonal sensitivity, and total life event stress were independently associated with functional GI disorders.

Locke GR 3rd, Weaver AL, Melton LJ 3rd, Talley NJ. Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case-control study. Am J Gastroenterol 2004 Feb; 99(2):350-7

Comment: Contrary to current dogma, psychosocial factors in this study were significantly associated with functional GI disorders in this community sample. This suggests that these factors may be involved in the etiopathogenesis rather than just being driven by health-care utilization. The preponderance of recent studies has tended to explain functional GI problems on a purely physical basis. With this study and those above, I rest my case: Gastrointestinal function affects mind-brain function and mind-brain function affects GI function.

Robert Anderson is a retired family physician. In mid-career, his practice took on a more holistic nature as decades passed. He has authored five major books, Stress Power! (1978), Wellness Medicine (1987), The Complete Self-Care Guide to Holistic Medicine (1999) (co-author), Clinician's Guide to Holistic Medicine (McGraw Hill, 2001), and The Scientific Basis for Holistic Medicine, (6th edition), newly available from American Health Press, holos@nwi.net. Anderson was the founding president of the American Board of Holistic Medicine, past president of the American Holistic Medical Association, former Assistant Clinical Professor of Family Medicine at the University of Washington and currently Adjunct Instructor in Family Medicine at Bastyr University.

COPYRIGHT 2004 The Townsend Letter Group
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