About 40% to 50% of the patients with gastrointestinal symptoms seen in gastroenterology departments do not have organic gastrointestinal diseases, but their symptoms are actually present, which is usually called functional gastrointestinal disease in clinical practice. Those who show symptoms in the upper gastrointestinal tract are usually called “functional dyspepsia”; those who show symptoms in the lower gastrointestinal tract are usually called “irritable bowel syndrome”. These two functional gastrointestinal disorders are closely related to psychological factors. ”Functional dyspepsia” is a group of clinical symptoms such as upper abdominal pain, bloating, early satiety, belching, anorexia, nausea, vomiting, etc. Various examinations confirm the absence of organic lesions of the liver, bile, pancreas, small intestine, as well as the stomach wall and gastric mucosa. “Irritable bowel syndrome” is another functional gastrointestinal disease with a high incidence, which is mainly characterized by gastrointestinal symptoms, such as abdominal pain, bloating, diarrhea, constipation, and relief after defecation. X-rays, endoscopy and ultrasound examinations on these patients did not show any abnormal findings. Zhang Zhixiong, Department of Gastroenterology, People’s Hospital of Guangxi Zhuang Autonomous Region The etiology of these functional gastrointestinal diseases is still unclear. What are the aspects of “abnormal psychological state”? After a systematic and standardized research, we found that among the personality factors, most of the above-mentioned patients have the following personality characteristics: 1, introversion: usually emotionally closed, less sociable, lonely, unconcerned about others, and difficult to adapt to the external environment. 2, high emotional nature: easily anxious, worried, often depressed, worried, emotionally reactive, and even not rational enough. The results of the anxiety and depression survey found that the above patients had much higher anxiety and depression scores compared to healthy people. There are also negative life events that occur in daily life that have a significant impact on the development of functional gastrointestinal disease. Common family problems include: failure in love and marriage, family discord, poor relationship or long-term separation, unsatisfactory sex life, family financial difficulties, serious illness or death of a family member, child discipline problems, housing tension; problems in work and study include: joblessness, layoff, failure in college entrance exams, excessive work and study pressure, tension with colleagues and superiors; in addition, there are misunderstandings by others, false accusations, involvement in legal disputes, property losses, etc. These negative life events can cause severe or mild mood disorders, some manifest as anxiety, some as depression, or both, and anxiety or depression can cause or aggravate the occurrence or worsening of symptoms of functional gastrointestinal disease. However, most patients are not aware that these psychological problems can cause or exacerbate their disease. They are usually reluctant to see a doctor about psychosomatic problems, ignoring the fact that psychosomatic abnormalities are an important cause of disease. In some large hospitals, gastroenterologists are very focused on these aspects of diagnosis and treatment. In the treatment of functional gastrointestinal diseases, medication is not the dominant treatment, and comprehensive treatment, including psychotherapy, should be emphasized. In terms of psychotherapy, a relationship of trust and communication needs to be established between the doctor and the patient over a longer period of time. The doctor should understand what the patient fears and explain to the patient in terms that the patient can understand that functional gastrointestinal disease is a benign disease that can be relieved but can also recur, and that psychological factors are closely related to it, such as stress and apprehension can aggravate symptoms. Patients should also adopt various suggestions from the doctor that can help them recover from symptoms, such as: maintaining an optimistic mood and trying to relax mentally; actively adjusting their lifestyle and regularizing their work and rest; and strengthening physical exercise. This is quite important in the whole treatment. While doctors give patients patient and meticulous psychological treatment, appropriate amounts of anxiolytic or antidepressant drugs (such as SSRIs, which are currently more effective) for patients with anxiety and depressive symptoms also have a significant effect on improving symptoms. Because the dose and delivery method of medications used to treat these functional gastrointestinal disorders greatly affects the efficacy, patients should be medicated under the guidance of a physician. Recognizing this, patients should allow full mental relaxation and first realize that the disease they are suffering from is benign, can be remitted and may recur, and that psychological factors are related to their disease. It is important to use positive behavior to remove tension, anxiety and depression. It is important to regularize your work and rest, especially during symptom attacks, engage in more activities that can divert your attention, stay optimistic, let your mind be fully relaxed, participate in more outdoor activities, and strengthen your physical exercise. It is important to pay attention to regular bowel movements at regular intervals. Patients with constipation need to increase the intake of fiber, polysaccharides, fructose, or lactose, while those with diarrhea should reduce the intake of these foods. Patients can document their lifestyle, including symptoms, bowel movements, diet, and medications, over a two-week period to determine which are the triggers of symptoms so that adjustments can be made accordingly. Physicians can achieve symptom relief by giving patient and careful explanatory work while focusing on psychotherapy, encouraging patients whose illness is triggered by unfortunate events to view physical discomfort and altered visceral function as expressions of anxiety resulting from these events rather than as illnesses requiring treatment. Placebo therapy is effective for half of the patients, and relaxation therapy, hypnotherapy, and music therapy are all effective. Biofeedback therapy, which has been developed in recent years, is effective in about 70% of patients. The therapy is widely used in patients with fecal incontinence and constipation, and can exercise patients to learn the best way to defecate. Anxiolytic or antidepressant treatment for patients with anxiety and depressive symptoms can also be effective in improving symptoms. It is important to let patients know that medication is not dominant and that if medication is needed, it should always be administered under the guidance of a gastroenterologist, as the dose and delivery method of medication can have a significant impact on the efficacy.