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Central and Peripheral Neuromodulators in Functional Dyspepsia and Gastroparesis: A Symptom-Based Clinical Review.

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Deconstructing stigma as a barrier to treating DGBI: Lessons for clinicians.

Jordyn H Feingold1, Douglas A Drossman2

  • 1Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Neurogastroenterology and Motility
|January 23, 2021
PubMed
Summary

Social stigma negatively impacts patients with disorders of gut-brain interaction (DGBI). Understanding and addressing stigma is crucial for improving treatment adherence and health outcomes in functional dyspepsia (FD) and other DGBI.

Keywords:
antidepressantsdisorders of gut-brain interactionfunctional dyspepsianeuromodulatorspatient-doctor communicationstigma

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Area of Science:

  • Gastroenterology
  • Psychiatry
  • Medical Sociology

Background:

  • Disorders of gut-brain interaction (DGBI), such as functional dyspepsia (FD), often lack clear structural causes.
  • These conditions are frequently misattributed to psychiatric issues due to high comorbidity and response to neuromodulators, leading to significant stigma.
  • Stigma in healthcare settings negatively affects patients, causing distress, non-adherence, and access barriers.

Purpose of the Study:

  • To review the prevalence and impact of stigma in patients with DGBI.
  • To explore the historical roots of stigma associated with DGBI, linking it to mind-body dualism.
  • To provide clinicians with actionable strategies to mitigate stigma and improve patient outcomes.

Main Methods:

  • This minireview synthesizes data from Yan et al. (Neurogastroenterol Motil, 2020).
  • Analysis of the psychological and social factors contributing to stigma in DGBI.
  • Identification of evidence-based interventions to reduce stigma.

Main Results:

  • Stigma is a pervasive issue in DGBI, stemming from historical mind-body dualism and misinterpretations of symptom etiology.
  • Adverse consequences of stigma include emotional distress, poor treatment adherence, and limited healthcare access.
  • Clinicians require guidance to effectively address and reduce stigma in DGBI patient care.

Conclusions:

  • Healthcare providers and patients must recognize the factors driving stigma in DGBI.
  • Implementing strategies to ameliorate stigma is essential for optimizing treatment adherence and clinical outcomes.
  • Further research and education are needed to combat the negative effects of stigma on DGBI patients.