A Comprehensive Approach to GI Care: Integrating Behavioral Health Interventions in Gastroenterology

In the practice of gastroenterology, where disorders of the gastrointestinal tract and liver are prevalent, healthcare providers are increasingly recognizing the consequential  interplay between physical health, mental health, and lifestyle factors in the management of these chronic conditions. In the pursuit of comprehensive care, the integration of behavioral health interventions is a powerful approach to improve patient outcomes and enhance overall quality of life.

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Behavioral health interventions encompass a wide range of approaches aimed at addressing the psychological and behavioral aspects of diseases and medical conditions. From addressing the psychological impact of a new diagnosis to managing chronic GI conditions and promoting adherence to treatment regimens, behavioral health interventions offer a versatile framework for delivering high-quality care. These approaches can also be used to help patients cope with the emotional and social challenges associated with living with chronic conditions, such as stigma, shame, and fear of disease progression and treatments. By providing emotional support and practical coping strategies, these interventions enhance patients' resilience and equip them to cope with the challenges posed by their condition.

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When it comes to disorders of gut-brain interaction, research has consistently demonstrated how psychological processes influence how our gut functions. For example, chronic stress can trigger a cascade of neuroendocrine responses that impact gut permeability, alter gut microbiota composition, and exacerbate inflammation. These physiological changes contribute to the pathophysiology of chronic GI disorders, underscoring the importance of addressing psychological well-being and stress in the management of these conditions.

Did you know? Behaviors and emotional responses such as avoidance of social situations, myths about constipation, gut-specific anxiety, and problematic toilet behaviors that develop over time perpetuate irritable bowel symptoms. When present, targeting these issues are an essential for recovery. 

Some examples of behavioral health interventions tailored to address GI conditions include relaxation training, diaphragmatic breathing, and addressing unhelpful thoughts related to illness perceptions, body image, and fear of worsening symptoms. Behavioral activation strategies can be employed to encourage patients to engage in pleasurable activities and maintain social connections despite the challenges posed by their condition.

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Metabolic liver diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), present unique challenges due to their close association with obesity, insulin resistance, and metabolic syndrome. Research strongly indicates that targeted dietary modifications and other lifestyle and behavioral changes  can lead to significant improvements in health outcomes/metabolic function.

Did you know? Behavioral health interventions for metabolic liver disease focus on promoting new health behaviors, such as addressing sleep and fatigue, as well as addressing unhelpful beliefs, all of which can make it harder for people to adhere to treatment recommendations.

These types of interventions empower patients to take control of their health and make sustainable lifestyle changes. Yet, behavior change remains a formidable challenge in routine clinical practice. Healthcare providers face obstacles in delivering individualized behavioral interventions due to limited time, inadequate training in evidence-based approaches, and resource constraints. Similarly, patients frequently encounter difficulties in translating clinical recommendations into meaningful and lasting lifestyle modifications without adequate information, support and structure to implement into their daily lives. Broad lifestyle changes can be hard for people to break down into achievable steps resulting in one feeling overwhelmed and defeated, resulting in decreases in motivation and treatment adherance.  

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Benefits for Gastroenterologists and Patients

The integration of behavioral health interventions into gastroenterology practices offers numerous benefits for both healthcare providers and patients. By addressing the psychological components of care, providers can enhance treatment outcomes, and optimize healthcare utilization while reducing medical costs associated with these chronic conditions.

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Virtual wraparound care, in particular, provides a novel approach to delivering behavioral health interventions in gastroenterology practices. By leveraging telehealth technology, like Salvo Health, providers can offer their patients personalized ongoing support and guidance throughout the treatment process. Virtual wraparound care offers more touchpoints for patient engagement, allowing clinicians to set up realistic goals, monitor progress, address barriers to treatment including motivation, and provide timely interventions when needed. This increased accessibility and flexibility can enhance patient engagement, momentum with behavioral changes, and satisfaction with care.

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Patients, in turn, benefit from improved symptom management, enhanced quality of life, and greater engagement in their care. By equipping patients with the skills and strategies to cope with the psychological challenges of living with GI and metabolic liver conditions, behavioral health support can empower them to take an active role in managing their health and well-being.

Get Started

For practices and health systems that want to speak to our team about how we can integrate Salvo Health’s RPM program into your workflow and EHR quickly and efficiently, contact Amanda Sussex at amanda@salvohealth.com.