Psychogastroenterology: A Comprehensive Approach to Functional Digestive Disorders.
Introduction
I recently had the honor of completing a summer course titled: "Psychogastroenterology: A New Vision of Functional Digestive Disorders". As a 5th-year Internal Medicine student assistant, it was an enriching experience to take on the role of speaker for students and healthcare professionals. In this article, I share the pillars of a discipline that is transforming our daily clinical practice by bridging the gap between mental well-being and digestive health.
Neurobiology of the Brain-Gut Axis
The brain-gut axis (BGA) is a bidirectional communication system that connects the central nervous system (CNS) with the enteric nervous system (ENS). This axis integrates neural, hormonal, and immunological signals that regulate both digestive functions and emotional and cognitive states.
The enteric nervous system, known as the "second brain," contains more than 100 million neurons that operate semi-autonomously. Key neurotransmitters such as serotonin (90% of which is produced in the gut), dopamine, and GABA mediate this communication, explaining the close relationship between digestive health and our psychological well-being.
Psychogastroenterology: Concept
Psychogastroenterology is an interdisciplinary discipline that integrates knowledge from gastroenterology, clinical psychology, and neuroscience. Its goal is to understand and treat functional digestive disorders from a comprehensive perspective, recognizing that psychological, social, and biological factors act together.
The biopsychosocial model applied to functional digestive disorders (FDDs) allows patients to be approached holistically, considering how stress, anxiety, and life experiences influence gastrointestinal physiology. Integrating these aspects significantly improves clinical outcomes and quality of life.
Epidemiology and Clinical Relevance
Functional digestive disorders (now referred to as disorders of gut-brain interaction) affect 15-20% of the global population. In Spain and Latin America, irritable bowel syndrome reaches prevalences of 10-15%. Their impact on quality of life is considerable: absenteeism from work, frequent medical visits, and high healthcare costs make FDDs a priority public health issue.
Treatments and Therapeutic Approaches
The current model advocates for a holistic vision. As highlighted by the most recent guidelines and studies (2021-2026), integrating brain-gut-directed therapies is essential:
Psychological therapies: Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) have been shown to reduce symptoms and improve quality of life.
Medical and nutritional interventions: Pharmacotherapy directed at the brain-gut axis, low-FODMAP diets, and the use of probiotics as a therapeutic complement.
Comprehensive approach: The psychogastroenterological approach surpasses the traditional biomedical model in efficacy and long-term sustainability.
Conclusion
As future professionals, we face the challenge of moving past a purely morphological model and embracing a more humane vision. Psychogastroenterology is not the future; it is an urgent and updated necessity of our medical present.
References:
Ramos Reyes, C. E. (2026). Conference: Psychogastroenterology: A New Vision of Functional Digestive Disorders. UCM-SC.
Feldman, M., Friedman, L. S., & Brandt, L. J. (2026). Sleisenger and Fordtran's Gastrointestinal and Liver Disease.
Gutiérrez-Repiso, C., et al. (2025). Advances in Microbiota and Psychobiotics in Disorders of Gut-Brain Interaction.
Keefer, L. (2023). Gut-Directed Psychotherapy: Clinical Integration in Gastroenterology.
ENMS (2026). Neurogastroenterology & Motility: Microbial Metabolites and Visceral Sensitivity.