Psychosocial and individual aspects of functional gastrointestinal disorders
This chapter reviews the psychosocial and individual aspects of functional gastrointestinal disorders (FGIDs), including evidence for the biopsychosocial model and explains how it underpins the brain-gut axis, specifically in relation to sexual abuse, personality factors and environmental factors on FGIDs. It provides practical recommendations in relation to applying a holistic integrative biopsychosocial approach in clinical practice. Among potentially important aetiological factors in FGIDs, there are a range of environmental factors – infection, alterations of the gut microbiome, diet and lifestyle. The chapter outlines the individual, social and psychological factors that have been studied in irritable bowel syndrome (IBS) and other FGIDs. Anxiety disorders are the commonest psychiatric comorbidity in FGIDs. As many as 67" have trait anxiety and 84" state anxiety in a large series of FGID outpatients. Two forms of anxiety in particular have been studied. The first is 'illness anxiety', and the second is 'symptom-specific anxiety'.