Functional gastrointestinal disorders: History taking skills in practice

Area of Science:

• Gastroenterology
• Psychiatry
• Primary Care Medicine

Background:

• Functional gastrointestinal disorders (FGIDs) are diagnosed using clinical history and Rome IV criteria, not biomarkers.
• Accurate diagnosis of FGIDs is crucial for timely intervention and preventing chronicity.

Purpose of the Study:

• To propose a structured history-taking framework for FGIDs based on the bio-psycho-social model.
• To enhance diagnostic accuracy and patient management for FGIDs.

Main Methods:

• Utilizing open and closed questions to assess gastrointestinal symptoms.
• Incorporating a multi-system approach, screening for alarm signs, and evaluating nutritional and social history.
• Exploring psychological comorbidities and identifying factors influencing FGID development and progression.

Main Results:

• The proposed framework integrates biological, psychological, and social aspects of FGIDs.
• History taking aims to build rapport, validate patient experiences, and reduce stigma.
• Education on the gut-brain axis facilitates symptom reattribution and patient reassurance.

Conclusions:

• Effective history taking is paramount for accurate FGID diagnosis and management.
• A bio-psycho-social approach improves patient understanding and acceptance of treatment.
• Patient engagement and understanding of the gut-brain axis are key to successful FGID treatment.