[The patient with refractory functional disorders of the gastrointestinal tract]

A group of patients with functional disorders of the gastrointestinal tract, manifest symptoms that are chronic, severe and invalidating. Their refractoriness to different treatments is a great challenge for physicians. They normally have a severe psychological and social dysfunction and an abnormal behavior towards their disease. All these factors lead these patients to perpetuate their illness condition. On the other hand, physicians usually have a negative reaction to their demands, leading to a non-satisfactory patient-physician relationship and to the failure of the healing process. Training in the systemic, biopsychosocial model of diseases and in interpersonal communication skills is required for an adequate management of these patients.