Gut Psychosomatics: When You Need a Specialist

Gastrointestinal complaints — pain, acid reflux, irritable bowel syndrome — are often treated as purely physical problems. A person spends years seeing a gastroenterologist, tries different diets, and still finds no relief. Or, on the contrary, attributes everything to "nerves" and sees no one at all. Both paths lead nowhere.

Why One Doctor Is Not Enough

Irritable bowel syndrome, in Dr. Saулitis's words, is "a shared disease of both the head and the gut." The same applies to reflux and other functional GI disorders. These conditions involve both physiological factors — stomach acidity, motility, eating habits, body weight — and the person's psychoemotional state. Neither a gastroenterologist alone nor a psychiatrist alone sees the full picture.

When to Seek Help — and From Whom

The following situations call for specialist attention:

• GI complaints persist despite treatment by a gastroenterologist.
• Symptoms worsen during periods of stress, anxiety, chronic fatigue, or poor sleep.
• Low mood, asthenia, or adjustment disorder are present alongside gut problems.
• You sense that "both your head and your stomach" are off, but don't know where to start.

In these cases, a team consultation is needed: a psychiatrist and a gastroenterologist assess the situation together. Where necessary, a psychotherapist or coach joins the process. This integrated approach targets the underlying cause rather than just suppressing symptoms.

The First Step: Not a Diet — a Diagnosis

Before changing your diet, trying supplements, or searching for psychological techniques, it is essential to understand what is actually happening — in the gut and in the nervous system. As Dr. Saулitis stresses: "First you need to understand the diagnosis — a diagnosis is always made by a specialist." Attempting to treat yourself without that understanding is like putting on a cast without knowing whether the bone is broken.