Psychogastroenterology of disorders of intestinal-brain interaction. Review with own research

Abstract

Disorders of the gut‑brain interaction (DGBI), previously known as functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional constipation (FC), are widespread worldwide (affecting 40% of the population in different periods of life). Modern understanding of pathophysiology of these conditions are determined by the bidirectional interaction between the intestine and the brain, represented by the biopsychosocial model, as well as changes in the intestinal microbiota, immune function of the mucous membrane, visceral hypersensitivity and abnormal motility of the gastrointestinal tract. Early detection, using symptom‑based criteria, and treatment of these disorders is crucial, as they significantly affect a patient’s quality of life and work capacity, creating a heavy burden on the health care system and entire society. Unfortunately, despite the available recommendations, consensus and a wide range of pharmacotherapeutic approaches, the problem of DGBI remains unresolved. The widespread reasons for the lack of effectiveness DGBIs treatment include stigmatization, late diagnosis and postponing the prescription of therapies affecting the gut‑brain axis, including delay in prescribing neuromodulators and the use of psychological treatment methods. The diagnosis of DGBI is based on the Rome IV criteria and should no longer be considered as a diagnosis of exclusion. Treatment approaches should be more personalized and based not only on symptoms, but also on underlying pathophysiological and psychological features. The purpose of this review is to inform clinicians about the main psychological approaches to the treatment of disorders of the gut‑brain interaction, which should be considered as a comprehensive treatment of DGBI. The purpose of this article is to inform clinicians about main psychological methods of psychotherapy (psycho‑correction) of gut‑brain‑interaction‑disorders, which should be considered as a comprehensive treatment of DGBI, among which biosuggestive therapy has already taken a special place.