A study that recommends including psychological symptoms when diagnosing a range of common gastrointestinal (GI) disorders has been named the 2024 clinical research paper of the year in the journal Neurogastroenterology and Motility.

First author, Professor Mike Jones (above) has been invited to visit London in September to present the team’s findings at the Biennial Meeting of the European Society of Neurogastroenterology and Motility.

Disorders of gut-brain interaction (DGBI) is an umbrella term for a range of non-organic conditions including irritable bowel syndrome (IBS), functional dyspepsia and functional constipation.

Unlike diseases with a clear organic cause, these conditions are challenging to group into discrete diagnoses. This is because they are defined almost entirely on patients’ reported symptoms, which tend to correlate poorly with identifiable underlying physical pathology.

For some time, there was uncertainty over whether the psychological comorbidities associated with condition like IBS were an innate feature of the disease, or a consequence of its physical symptoms.

Despite mounting evidence that comorbid psychological conditions such as anxiety have an important role to play in the cause and maintenance of DGBI, the most commonly used diagnostic criteria, known as the Rome IV criteria, still include no psychological symptoms.

The new study surveyed about 56,000 people from more than 20 countries to create profile models based on GI symptoms alone and a combination of GI and psychological symptoms.

It showed diagnostic classifications would be substantially different if both physical and psychological symptoms were included in the diagnostic process. Optimal diagnostic procedures are crucial, because a physician’s choice of treatment is typically based on their diagnosis.

Professor Jones says with IBS alone affecting up to a one in seven Australian adults, improving the way GI conditions are classified has the potential to help optimise diagnosis and lead to improved selection of therapies to improve outcomes for many patients.

“Unfortunately, trying to recast an entire diagnostic system is well beyond the capacity of one study,” he says.

“Even to go from what we’ve done to considering substantially modifying the criteria is an immense task.

“The next revision of the diagnostic criteria, Rome V, is currently underway, so this may well carry over to Rome VI.

“Until then, we hope that this could still help patients by encouraging physicians to include a patient’s psychological symptoms in their consideration of which treatments to recommend.”

Professor Mike Jones has been studying the gut-brain axis for 40 years. He is a professor in the School of Psychological Sciences, a member of the Lifespan Health and Wellbeing Research Centre and Deputy Dean (Research and Innovation) in the Faculty of Medicine, Health and Human Sciences.