“Psychogenic” is Not the Be-All and End-All
The topic of irritable bowel syndrome is repeatedly discussed in Deutsches Ärzteblatt, but unfortunately one-sided. I miss the groundbreaking study from 2014 by Prof. Annette Fritscher-Ravens, in which she showed that 22 of 36 patients with the diagnosis irritable bowel syndrome suffered from a specific food intolerance (1).
While the method used is certainly not suitable for routine examination, it should show us that we will have only limited success if we treat with a therapy that is based on a biopsychosocial disease model. Indeed, it underscores the need to develop methods that allow a simpler way to identify these food intolerances.
With the increasingly prevalent attitude that illnesses that cannot be explained using conventional methods should be classified as psychogenic, we are helping neither our patients nor ourselves, but are rather causing psychological suffering and comorbidity—and also, of course, doctor hopping
Dr. med. Astrid Spangenberg
Zentrum für Seltene Erkrankungen
Medizinische Hochschule Hannover, Germany
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Fritscher-Ravens A, Schuppan D, Ellrichmann M, et al.: Confocal endomicroscopy shows food-associated changes in the intestinal mucosa of patients with irritable bowel syndrome. Gastroenterol 2014; 147: 1012–20 CrossRef MEDLINE|
|2.||Häuser W, Marschall U, Layer P, Grobe T: The prevalence, comorbidity, management and costs of irritable bowel syndrome—an observational study using routine health insurance data. Dtsch Arztebl Int 2019; 116: 463–70 VOLLTEXT|