Can GI psychologists help with ulcerative colitis?

Living with ulcerative colitis (UC) can be stressful and can also affect mental health through the gut-brain axis. Gastrointestinal (GI) psychologists can help people cope and manage psychological symptoms that can lead to flares.
UC is one of two primary types of inflammatory bowel disease (IBD). It causes chronic inflammation and ulceration within the large intestine and the rectum. Bloody stools, abdominal pain, and a feeling of bowel urgency are common symptoms.
Unlike Crohn’s disease (CD), the other primary type of IBD, UC does not affect other parts of the GI tract. However, like many GI conditions, it can influence a person’s mental health in more ways than one.
Living with UC can be stressful, and chronic stress can contribute to decreased quality of life and challenges such as anxiety and depression. There is also a connection between UC and mental health through the gut-brain axis, a two-way neurological communication pathway between the gut and the brain.
The gut-brain axis makes it so that conditions affecting the gut can influence a person’s mood and mental state, while a person’s mental state and emotions can also affect the function of the gut.
This article discusses the role of GI psychologists in the treatment of UC and how they support overall UC management.
Psychologists are licensed professionals who hold a doctoral degree in a psychological field such as clinical psychology. They specialize in mental health, emotional well-being, and interpersonal relationships. They can evaluate, diagnose, and provide psychotherapy for the management of mental health conditions.
A GI psychologist focuses on the mental health effects of living with a gastrointestinal condition.
“A GI psychologist is an expert in understanding the two-way connection between the brain and the gut,” explained Dr. Megan Riehl, GI psychologist and assistant professor of medicine at the University of Michigan. “They specialize in evidence-based treatments for conditions like irritable bowel syndrome (IBS), functional abdominal pain (FAP), IBD, and other gastrointestinal disorders.”
She adds that these specialists work collaboratively with people and their healthcare teams to assess the biological, psychological, and social factors contributing to GI distress.
Research suggests that as many as 50% to 94% of people with disorders of gut-brain interaction (DGBI), formerly referred to as functional gastrointestinal disorders, live with a co-existing mental health disorder. It also suggests as many as 38% experience suicide ideation related to GI symptoms.
Depression and anxiety are common in IBD and may affect the severity of UC symptoms and the frequency of relapse through the gut-brain connection.
GI psychologists work to improve a person’s overall quality of life in UC by helping build coping mechanisms and resilience that promote mental well-being.
Each person’s experience with UC is unique, and GI psychologists tailor therapy to those individual needs. UC severity, disease course, a person’s mental health symptoms, and lifestyle all influence a long-term management plan.
According to Riehl, GI psychologists develop targeted treatment plans that combine education with evidence-based, therapeutic interventions such as GI-specific cognitive behavioral therapy (GI-CBT) and clinical hypnosis, also called gut-directed hypnotherapy.
“These approaches not only address GI symptoms but can also help manage co-occurring conditions like anxiety, panic, and depression, enhancing overall well-being,” she said. “Using evidence-based techniques like cognitive behavioral therapy, gut-directed hypnotherapy, and mindfulness strategies, GI psychologists support patients in reducing symptom severity, improving their quality of life, and gaining greater control over their condition.”
While each person’s treatment plan is individualized, Riehl explains common therapeutic goals include:
- identifying how stress, anxiety, or depression can influence inflammation and symptom flares in UC
- enhancing and developing coping skills to manage unpredictable symptoms, fatigue, and other effects on quality of life
- developing emotional resilience
- navigating challenges with body image concerns, stigma, and the effect of UC on relationships
- supporting treatment adherence, dietary plans, and lifestyle modifications
- addressing barriers to adherence, such as medication fears or frustration with the chronic nature of UC
How do GI psychologists work with other healthcare professionals?
GI psychologists work alongside other GI professionals as a diverse team focused on the most effective, well-rounded UC management.
“A GI psychologist collaborates closely with other GI specialists, including gastroenterologists, dietitians, primary care and nurse practitioners to provide comprehensive, multidisciplinary care for patients with GI disorders,” Riehl said. “This teamwork ensures that patients receive holistic care addressing both physical and psychological aspects of their condition.”
UC is a chronic condition that causes inflammation and ulceration of the large intestine and rectum. As a lifelong condition, UC can be stressful and contribute to mental health challenges like anxiety and depression.
UC can also affect a person’s mental health through the gut-brain axis, a two-way communication pathway between the brain and the gut.
GI psychologists specialize in addressing the mental health effects associated with gut-brain disorders like UC. They help people develop coping skills, address challenges related to quality of life, and build emotional resilience.
The Rome Foundation, an organization dedicated to providing support to diagnose and treat DGBIs, maintains a healthcare directory that people can use to look for GI psychologists in their area.
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