By tf-lawyer.com Have you ever experienced digestive discomfort like stomach pain, bloating, or diarrhea when feeling tense or anxious? Why might individuals with obsessive-compulsive traits or perfectionism be more prone to gastrointestinal issues?
In recent years, as the pace of modern life accelerates, many people face intense academic and work pressures, which can lead to negative emotions. This increase in stress-related psychological and digestive disorders has caught the attention of clinicians. On World Mental Health Day, October 10, the China News Agency spoke with Xiao Xue, the deputy chief psychiatrist at Tsinghua University’s affiliated Beijing Tsinghua Changgung Hospital, and Ren Yutang, the deputy chief of the gastroenterology department at the same institution, to explore the mental health factors underlying these digestive concerns.
“Feeling nauseous at the thought of something” reflects the interaction between two “brains.”
The gut is often referred to as the body’s “second brain,” housing its own nervous system known as the enteric nervous system, which has a bidirectional connection with the central nervous system in the brain.
Ren Yutang explains, “For some individuals, anxiety can lead to stomach pain, diarrhea, or bloating, but these symptoms usually disappear once the stressor is gone. This is a common understanding of the gut’s role as the ‘second brain.’”
Research indicates that gastrointestinal symptoms are tied to the interplay between the gut and the brain. For example, during rectal balloon distension testing, individuals in a tense state may experience heightened discomfort or pain, illustrating a sensitization of visceral sensations. The perception of symptoms can vary significantly depending on the emotional state of the patient when presented with the same gastrointestinal challenge, showcasing the reciprocal influence between the brain and gut. Moreover, when gastrointestinal symptoms arise, they can create feelings of distress and discomfort through their connection with the brain.
What insights and observations exist from the perspective of psychosomatic medicine regarding the gut-brain interaction?
Xiao Xue notes that some common phrases in everyday language reflect the link between psychology and the digestive system. For instance, people often say, “Just thinking about it makes me nauseous,” or “Seeing it makes me feel like throwing up.” These feelings of nausea and vomiting can express a strong sense of aversion and rejection from a psychodynamic perspective. She recounts a typical case where a child felt nauseated before attending school but was fine at home. “After diagnosis, it became clear that deep down, the child harbored a fear of school, leading to the nausea and vomiting as a physical manifestation of this anxiety.”
Xiao further explains that research into personality traits reveals that those with obsessive-compulsive tendencies or a pursuit of perfection are more likely to experience gastrointestinal dysfunction. These individuals often exist in a state of heightened tension, which can disrupt digestive functions. Additionally, unhealthy habits like excessive dietary control or picky eating can impair the gut’s normal digestive and absorption capabilities. Personality types that struggle to express or release stress—such as those with melancholic traits—may also experience symptoms like gastrointestinal spasms and pain due to long-term emotional suppression.
Regarding common issues like constipation and diarrhea, Xiao mentions that people who suffer from constipation often exhibit characteristics of avoiding the revelation of certain hidden aspects of themselves. “In treatment, we encourage patients to confront and release those hidden emotional responses.”
Collaborative care between psychology and gastroenterology is essential in addressing the evolving spectrum of diseases.
“Ten years ago, when I was seeing patients, I encountered many cases of organic gastrointestinal diseases like peptic ulcers and ulcerative colitis. However, as society has developed, I’ve noticed a decline in organic diseases within my practice, with a significant rise in functional gastrointestinal disorders that often co-occur with notable psychological issues. The landscape of illnesses has changed dramatically over the past decade,” Ren Yutang shares.
Reports indicate that psychosomatic disorders of the digestive system now rank at the top among internal medicine’s psychosomatic diseases, with 45% to 75% of digestive disorders accompanied by psychosocial factors—a trend that continues to increase. Yet, the concept of “digestive psychosomatic diseases” has only recently emerged, indicating that there is still much ground to cover in raising public awareness and understanding.
Currently, there are very few integrated clinics for digestive psychosomatic issues in Beijing. Since May of this year, Ren and Xiao have initiated a collaborative care model at Beijing Tsinghua Changgung Hospital. They see numerous challenges in treating the growing patient population affected by these diseases.
Xiao believes that many patients find it difficult to openly discuss deep-seated issues. Additionally, a limitation in general hospitals today is the insufficient time allocated for outpatient consultations. She explains, “Non-mental health professionals often rely more heavily on objective tests for diagnosing internal or surgical diseases rather than engaging in thorough conversations. If no anomalies are found through objective testing, patients’ real bodily discomfort might not receive the attention it deserves.”
Ren emphasizes that traditional medical models focus predominantly on the biological features of illnesses but overlook the psychological, mental, and sociological aspects. The integrated “biopsychosocial” model, centered around patient involvement in decision-making, is still relatively lacking in the country. “We prioritize diseases, but even more so, we prioritize the individuals experiencing them. This is a crucial treatment philosophy in our digestive and mental health outpatient care. We are likely to encounter a growing number of patients with psychosomatic disorders, which will create an even larger gap in healthcare providers for these conditions, straining resources. Therefore, we advocate for incorporating medical psychology, psychiatry, and behavioral medicine into medical education from an early stage,” he asserts.
“Beyond the digestive system, psychosomatic medicine has the potential to benefit patients with issues in various other systems, including those with pain or neurological disorders. We aspire to minimize patient discomfort through an interdisciplinary approach to treatment, offering substantial support from both mental and physical health perspectives,” Xiao concludes.
