Dynamism of Psychosomatic Medicine

<p>When I was a medical student, through an encounter with a high school student with leukemia at a terminal stage, I decided to be a specialist of psychosomatic medicine. Thirty years have passed since I reported that cancer therapy based on the truth including notification of cancer resulted in a good patient-doctor relationship at the meeting of PSM on digestive diseases. After more than five-year-long practical experience as an internist and gastroenterologist at a middle class of the public hospital where the certified mentor of psychosomatic medicine had been working, I belonged to the Aichi Medical University and Fujita Health University School of Medicine for 23 years during which I did a basic medical research on brain-gut interaction at University of California, Los Angeles (UCLA) for one and a half year. Relationship between functional dyspepsia (FD) and psychological characteristics/gut hormone had been researched at the universities. We have established a nutrient drink test for measuring the human gastric function including threshold of discomfort sensation and adaptive relaxation volume in an easy and non-invasive way. The visual and auditory stress which induced discomfort feeling in normal volunteers resulted in appearance of stomach pain (epigastralgia) and reduction of maximal drinking volume which was among the characteristics of FD. Noise stress applied to the rats increased the contraction of gastric antrum and number of immunoreactive thyrotropin-releasing hormone (TRH) positive cells in the brain stem. These lines of experimental results in humans and rats suggested that discomfort feeling derived from a certain stressor may cause epigastralgia accompanied by changes of the motility and sensation of the stomach. The evidence-based clinical practice guidelines for FD 2014 recommends hypnotherapy by a specialist for intractable patients with FD, however, only a few institutes have performed the therapy. Under the tuition of Professor Yvette Taché at UCLA who discovered that TRH injected into the central nervous system increased the rat gastric acid secretion for the first time in 1980, gastric protective action of endogenous TRH in the brain stem was demonstrated and published in “Gastroenterology”. In terms of irritable bowel syndrome (IBS), central oxytocin which has been reported to be closely related with trust and love decreased the water-avoidance stress (that is among the typical animal models of IBS) -induced hyper-contraction of the rat colon. Necessity of the viewpoint of developmental disorders and usefulness of electroencephalogram-based biofeedback (neurofeedback) has been proved in a certain group of IBS patients.</p>