The gastroenterology section at Baylor College of Medicine witnessed a growing number of patients with mental health needs who were not getting the psychological care they needed. The patients were not always comfortable bringing up psychological issues, and the physicians found it difficult to find psychologists with knowledge of digestive disorders. That all began to change once Andrea Bradford, Ph.D., joined the clinic in 2016.
Dr. Bradford works with about a dozen gastroenterologists to care to care for patients with functional bowel disorders, inflammatory bowel disease, esophageal reflux disorders, bowel cancer and other gastrointestinal problems that can cause anxiety, depression, and even sexual dysfunction.
“We are promoting the concept of digestive wellness, which, in addition to traditional medical care for the digestive system, encompasses a focus on diet and nutrition and mental and psychological well-being”, says Dr. El-Serag, chief of the gastroenterology department at Baylor. Dr. El-Serag hired a dietician at the same time he hired Dr. Bradford. Most chronic digestive disorders are associated with stress and poor coping mechanisms, Dr. El-Serag explains. “At a minimum, psychological stress worsens the quality of life for patients with digestive disorders and reduces the effects of medical therapy. In some cases psychological factors may be responsible for the disorders in the first place”.
Only half a dozen gastroenterology clinics in the United States have a full-time psychologist on their treatment teams, says Dr. El-Serag. Psychological treatment usually does not affect the gastrointestinal disorder itself, says Dr. Bradford. What it does is change the way patients think about and respond to their symptoms, which can help them manage their pain and reduce visits to the clinic or emergency room.
Research supports two types of psychological treatment for gastrointestinal patients: Cognitive-Behavioral Therapy and hypnosis. Six to eight sessions of cognitive-behavioral therapy can help patients manage their symptoms, return to their normal activities and overcome their isolation.