What is Integrative Gastroenterology?

The term integrative gastroenterology refers to a multidisciplinary approach that combines conventional medical treatments with complementary interventions and lifestyle changes in order to optimise the care of patients with gastrointestinal diseases. The most robust studies on this topic highlight three main areas: multidisciplinary interventions, mind–body therapies, and the rational use of herbal medicines and supplements.

A randomised study by Basnayake et al. demonstrated that a multidisciplinary approach (including a gastroenterologist, nutritionist, hypnotherapist, psychiatrist and physiotherapist) resulted in greater improvement in symptoms, quality of life and cost-effectiveness compared with standard care provided by a gastroenterologist alone, particularly in functional disorders such as irritable bowel syndrome. [1]

The American Gastroenterological Association recommends the integration of psychogastroenterology, emphasising the role of the brain–gut axis and the importance of interventions such as cognitive behavioural therapy and gut-directed hypnotherapy for functional disorders and organic diseases, including inflammatory bowel disease. These interventions reduce symptoms, anxiety and healthcare costs, and are considered first-line practices in appropriate contexts. [2]

The Rome Foundation report reinforces that behavioural therapies based on the brain–gut axis are effective and should be integrated into clinical care. [3]

Fig. 1 - Integrative Gastroenterology

1. Long-Term Outcome of Multidisciplinary Versus Standard Gastroenterologist Care for Functional Gastrointestinal Disorders: A Randomized Trial. Basnayake C, Kamm MA, Stanley A, et al. Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association. 2022;20(9):2102-2111.e9. doi:10.1016/j.cgh.2021.12.005.

2. Best Practice Update: Incorporating Psychogastroenterology Into Management of Digestive Disorders. Keefer L, Palsson OS, Pandolfino JE. Gastroenterology. 2018;154(5):1249-1257. doi:10.1053/j.gastro.2018.01.045.

3. A Rome Working Team Report on Brain-Gut Behavior Therapies for Disorders of Gut-Brain Interaction. Keefer L, Ballou SK, Drossman DA, et al. Gastroenterology. 2022;162(1):300-315. doi:10.1053/j.gastro.2021.09.015.