Chronic gastrointestinal / respiratory / cardiovascular / or unknown origin issues

Chronic gastrointestinal / respiratory / cardiovascular / or unknown origin issues


Modern medicine has made great technological progress over the last 50 years. Our diagnostic methods have improved in many ways and are able to detect chronic illnesses in a much earlier stage then back in the 20. century. As an example for all may be mentioned the colonoscopy, which was introduced back in 1970 and has gained a paramount importance in diagnosing and treatment of colon cancer. 

However, in spite of all this progress, there are still many medical conditions we are not able to detect or understand easily. Exactly for their evasive nature they have received several different names or labels, such as functional, somatoform or psychosomatic disorders. In recent years a new “brand” emerged – Medically unexplained symptoms (MUS). According to studies patients with MUS comprise from 15 to 30% of all primary care consultations with the General Practitioner (1). The symptoms can affect any of the main body systems, including gastro-intestinal, respiratory or cardiovascular. Often it shows as a whole syndrome of symptoms as in chronic fatigue syndrome or burn-out-syndrome. Typically, the patient is experiencing very pronounced bodily symptoms, e.g. pain, burning, discomfort, nausea, dizziness, rapid heart beating and many more, but without any significant objective medical finding. This is why MUS are stressful not only for the patient, but for doctors as well. In some cases patients are being sent for multiple and sometimes even repetitive examinations in the hope to find the objective root of the disease. The more investigations stay negative, the more help- and hopeless the patient feels, what again can fuel the stress and augment the symptomatology. To get out of this vicious cycle must not be easy at all. A good first step is a comprehensive psychosomatic examination by a medical specialist being able to evaluate both aspects of the issue – the biological and the psychosocial one. From there, the most effective treatment can be chosen, but always has to be highly individual since personal and intimate aspects of the patient ´s life are involved. It can be psychosomatic treatment, psychotherapy, systemic therapy including family therapy or a combination with medication. Sometimes the bothering symptoms resolve rather quickly and there are cases, where the therapy has to continue longer. However, what always applies is the key fact, that the sooner the treatment is started the better the prognosis.


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(1) Explaining medically unexplained symptoms, Laurence J Kirmayer et al., OCT 1, 2004, Canadian Journal of Psychiatry