Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice | May 2025-BO Jagielski Riehl

BO Jagielski Riehl - From Tension to Treatment

Pdf Summary

The document highlights the importance of trauma-informed care in managing patients with gastrointestinal (GI) complaints, emphasizing its relevance in the context of pelvic floor dysfunction. Both Dr. Christina Jagielski and Dr. Megan Riehl from the University of Michigan are central figures in this discussion. The focus is on recognizing the high prevalence of psychological trauma among patients with GI disorders, and how trauma-informed care can mitigate associated barriers and improve patient outcomes.<br /><br />Psychological trauma is defined as harmful events that have lasting adverse effects on individuals. It is common, with 60% of men and 50% of women likely to experience trauma in their lifetime. This trauma significantly affects GI patients, with a notable percentage of those with inflammatory bowel disease or dyssynergic defecation reporting histories of trauma.<br /><br />Medical trauma, specifically iatrogenic trauma from encounters with the healthcare system, can exacerbate GI problems and deter patients from necessary procedures. The document outlines the complexity of medical post-traumatic stress, highlighting that 22-33% of patients with dyssynergic defecation have abuse histories.<br /><br />Trauma-Informed Care (TIC) is suggested as an effective approach to care that includes screening, communication, monitoring for distress, and creating a supportive environment. The importance of routine trauma screening is emphasized, especially before invasive procedures to prevent iatrogenic harm. Practical steps like obtaining patient consent at various stages and managing distress are outlined through case examples.<br /><br />Lastly, the document stresses that TIC requires input from the entire healthcare team and is distinct from trauma-focused treatment. It aims to create a safe environment for all patients, not just those with PTSD, improving patient satisfaction and reducing harm. Trauma-informed care is presented as a crucial component of patient-centered care in the GI field.

Keywords

trauma-informed care

gastrointestinal complaints

pelvic floor dysfunction

psychological trauma

iatrogenic trauma

dyssynergic defecation

screening and communication

patient outcomes

University of Michigan

patient-centered care