PhD defence Sylvester Raymond Bruls-Groen

Keywords: Disorders gut-brain interaction, Irritable bowel syndrome, Quality of life, Psychological comorbidity

"Towards personalized care: Unraveling biopsychosocial profiles in disorders of the gut-brain interaction"

Disorders of gut–brain interaction (DGBI), including irritable bowel syndrome, functional dyspepsia, and fecal incontinence, are among the most frequently encountered conditions in gastroenterology. Patients experience chronic symptoms with a substantial impact on daily functioning, healthcare utilization, and health-related quality of life, while identifiable structural abnormalities are often absent. Despite this complexity, these disorders are still largely diagnosed and treated through a symptom-based approach, leaving many underlying mechanisms insufficiently addressed. From visceral hypersensitivity and the (over)expression of specific receptors to psychosocial determinants such as anxiety, depression, personality traits, and their influence on quality of life and well-being, DGBI are increasingly recognized not as isolated gastrointestinal disorders, but as the result of a complex interplay between biological, psychological, and social processes. At the same time, the findings in this thesis highlight the limitations of a purely symptom-oriented diagnostic framework, in which syndrome overlap, psychological burden, and patient-specific phenotypes often remain underrecognized.

By integrating biological and psychosocial mechanisms, this thesis contributes to a broader perspective on DGBI: one that moves beyond isolated symptoms and anatomical classifications toward more personalized, biopsychosocial care focused on the patient as a whole.

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