How Psychological Support Can Help GI Patients

If you have inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), celiac disease or another gastrointestinal (GI) condition, your stress, mental health, thoughts and behaviors can have a significant impact on your digestive symptoms and daily life.

The Mind-Gut Connection for People with Digestive Diseases

At the University of Chicago Medicine, we believe that understanding this “mind-gut connection” is an important part of managing your digestive health. We are among a select group of centers in the United States offering specialized expertise and resources in GI psychology.

If you are coping with a digestive disease or condition, our experts can provide individually tailored strategies to help improve your symptoms and quality of life in just a few sessions.

Frequently Asked Questions About the Mind-Gut Connection

Your brain and your digestive tract (what GI specialists sometimes refer to as the “gut”) are connected by a communication pathway called the gut-brain axis. Specifically, your brain (part of your central nervous system) communicates back and forth with your digestive tract’s enteric nervous system. Along this pathway, your gut sends a steady stream of messages to the brain about how hungry or full you are, the nutrients in the food you eat and other status updates. Likewise, your brain sends messages to your digestive tract about your emotional state and stress level.

Stress can be caused by physical health concerns (such illness or injury) or emotional and mental health concerns (such as stress, depression or anxiety). When stress becomes chronic, the communication pathways between your brain and gut do not work like they should. This faulty gut-brain communication can cause GI symptoms or make an existing GI illness worse. These symptoms cause even more stress, creating a vicious cycle.

A GI psychologist teaches strategies that help manage stress and ease symptoms so you can start to feel better. They are specially trained in helping people change the way they think about and cope with their GI symptoms. They can also provide recommendations to help connect you to providers specializing in emotional and mental health concerns, which may require additional treatment.

Stress and other emotional factors can negatively affect all GI conditions. If you are dealing with a chronic GI condition, your enteric nervous system may become hyperreactive to food, gas or acid in your gut. This can cause pain, discomfort and other GI symptoms.

Some conditions, such as IBS or functional dyspepsia (indigestion), are very sensitive to stress. The symptoms of IBS, such as abdominal pain and changes to bowel habits, can often be triggered by stress. Stress can also make GERD, IBD and peptic ulcers worse.

If you think stress is affecting your digestive health, you don’t have to suffer on your own. A GI psychologist at UChicago Medicine can help you find practical ways to manage your stress and GI symptoms.

Just like stress and mental health issues can contribute to GI disorders, digestive conditions can contribute to anxiety, depression and other mental health problems.

For example, it’s not uncommon for someone with ulcerative colitis or Crohn’s disease to be anxious about finding a toilet in public. Or they may become depressed because their symptoms are affecting their quality of life.

If you feel depressed or anxious or just need some support coping with your chronic condition, a GI psychologist can suggest ways to help you feel better emotionally and physically.

Yes, a GI psychologist can help if your GI disorder is affecting your mental and sexual health. For example, if you have IBD, your symptoms or treatment may cause body image issues that can contribute to sexual dysfunction.

Fortunately, there are a number of strategies that you can learn with a GI psychologist to improve your intimacy and quality of life.

What does a GI psychologist do?

GI psychologists are specially trained to work with patients who have a range of problems including IBD, IBS, heartburn and other conditions. They have doctoral degrees in clinical psychology and have completed specialized training in GI psychology (also known as psychogastroenterology).

GI psychologists are specially trained in helping patients manage GI-specific anxiety and coping behaviors, which may be enough for many GI patients. However, if patients need additional treatment for concerns like ongoing or severe depression and anxiety, substance use or eating disorders, your gastroenterologist or a GI psychologist can make referrals and recommendations for the kind of care that will best address your needs.

How can GI therapy help GI symptoms?

GI psychologists typically use cognitive-behavioral therapy (CBT) techniques to help you understand how your thoughts and behaviors affect how you feel physically and emotionally. A GI psychologist also can help you enhance and change your thinking patterns and coping behaviors to reduce your stress and your GI symptoms. These tools are personalized to your particular goals and needs.

A GI psychologist also can teach you specific techniques like deep breathing and muscle relaxation to help you improve your body’s relaxation response, which can help reduce symptoms like pain, cramping, diarrhea, constipation and other common GI complaints. One of these techniques is gut-directed hypnotherapy, which has been shown to reduce symptoms in many people with IBS and other GI disorders.

How many sessions with a GI psychologist do I need?

It’s not uncommon for people to realize significant symptom relief after just six to eight sessions with a GI psychologist. Some people may feel better and cope better with their symptoms after just two or three sessions.

During your first meeting, the GI psychologist will take time to get to know you and learn more about your GI condition. You will be able to share what has worked (and what hasn’t) to manage your symptoms. From there, the GI psychologist will help you develop a personalized plan to reach your goals. Your goals may include having fewer symptoms, feeling less isolated or anxious and having a greater sense of control over your life.

Alyse Bedell, PhD

Alyse Bedell, PhD

Dr. Alyse Bedell is a GI psychologist who is specially trained to help patients develop coping behaviors for GI-related stress and anxiety.

See Dr. Bedell's profile