It is everyone’s dream to have a good appetite and to “eat well” in the face of delicious food. However, there are always some patients who are not so fortunate, and they have to go to the hospital for various blood tests, barium meal X-rays and even gastroscopy and enteroscopy to look for lesions in the gastrointestinal tract because of various gastrointestinal symptoms. Of course, the majority of these patients ultimately conclude that no significant abnormalities are seen. What causes most patients to have various symptoms without lesions in the gastrointestinal tract structure is the dysfunction of the gastrointestinal tract. In order to describe the above situation in more detail and to make it easier to understand, the causes, manifestations and drug treatment of this disorder are further elaborated based on the previous article “Let you eat well…”. Gastrointestinal dysfunction, also known as gastrointestinal neurosis, is a general term for a group of gastrointestinal syndromes, accounting for about 30% of patients in the gastrointestinal specialty, commonly found in students, white-collar workers, women, and people engaged in technical work or mental labor. The symptoms are acid reflux, anorexia, nausea, vomiting, postprandial abdominal pain, abdominal distention, and changes in bowel habits. Among them, they are specifically divided into gastric neurosis, in which stomach symptoms are dominant, and irritable bowel syndrome, in which intestinal symptoms are dominant. According to a large number of clinical studies, although the exact etiology of gastrointestinal tract dysfunction is not very clear, mental factors are the main triggers for the occurrence of this disease, such as emotional tension, anxiety, difficulties in life and work, worries, and unexpected misfortunes, etc., which can lead to affect the normal activities of gastrointestinal function and then cause dysfunction of the gastrointestinal tract. Studies have also shown that the intestine is a target organ of mental stress, and harmful mental stimuli can easily cause gastrointestinal dynamics disorders. Animal experiments have found that stress can cause functional colonic motility disorders in rats, and there is an increase in the release of some gastrointestinal hormones after receiving stimuli, indicating that neuroendocrine regulation is involved in the response process of gastrointestinal dysfunction caused by stress. In addition, external stimuli such as food, drugs, microorganisms, and certain metabolites produced during digestion can excite the sensitized murine intestine can significantly induce murine gastrointestinal contractile activity and produce diarrhea. When these stimuli are repeatedly applied to the gastrointestinal tract, it is possible to alter its sensorimotor function and sensitivity to stimuli, thus making the gastrointestinal tract “irritable”. The onset of gastrointestinal disorders is slow and the clinical manifestations are mainly gastrointestinal symptoms. Patients with gastrointestinal neurosis often present with acid reflux, belching, anorexia, nausea, vomiting, burning sensation under the glabella, post-feeding fullness, and epigastric discomfort or pain, which worsens with emotional changes. Patients often have abdominal pain, bloating, bowel sounds, diarrhea and constipation, and left lower abdominal pain with palpable strips. Abdominal pain is often aggravated by eating or cold drinks and is relieved after defecation, exhaustion and enema. The abdominal pain is often accompanied by abdominal distension, a feeling of dyspareunia or an increase in the number of bowel movements, and the stool can be thin or dry. In addition, patients also have dizziness and headache, chest tightness and palpitation, insomnia and dreaminess, distraction, nervousness and fear, menstrual disorders and other manifestations of plant nervousness outside the gastrointestinal tract. If the above symptoms are not treated in time, the quality of life of patients will be reduced and work and rest will be affected; in serious cases, the metabolic functions of the body will be seriously interfered with, resulting in insufficient energy supply, impaired nutrient absorption, anemia and vitamin deficiency, and even long-term mental anorexia and severe malnutrition will be formed. Therefore, gastrointestinal dysfunction is not a problem that can be treated or not, but should be given sufficient attention. Of course, before diagnosing gastrointestinal dysfunction, relevant tests need to be completed in order to differentiate it from organic gastrointestinal diseases. Generally, blood tests such as biochemical, immunological and tumor markers, X-ray, gastroscopy, gastric fluid analysis and fecal tests are taken according to different situations. If necessary, abdominal ultrasound, CT and other examinations should be performed to exclude liver, biliary, pancreatic and other abdominal organ lesions. In case of persistent abdominal pain with weight loss, barium meal of the whole gastrointestinal tract should be done to exclude Crohn’s disease; in case of persistent postprandial upper abdominal pain, ultrasound of the gallbladder should be done; in case of suspected pancreatic disorders, abdominal CT and amylase determination should be done; in case of suspected lactase deficiency, lactose tolerance test should be done; small intestinal mucosal biopsy should be done to exclude small intestinal mucosal diseases; colon mucosal biopsy can exclude colitis or tumors. Neurotic vomiting should be differentiated from chronic gastric disease, pregnancy vomiting, uremia, high cranial pressure, etc. Anorexia nervosa should be differentiated from gastric cancer, early pregnancy reaction, hypopituitarism or hyperaldosteronism. The treatment of gastrointestinal disorders does not focus on drugs, but on the usual diet. Only through mental adjustment and behavioral changes can gastrointestinal dysfunction be fundamentally adjusted. The intake of gas-producing foods (dairy products, soybeans, lentils, etc.) and high-fat foods that inhibit gastric emptying should be reduced in response to the patient’s dietary habits and their relationship to symptoms. The intake of high-fiber foods (such as coarse grains, vegetables, and fruits) can be increased appropriately, which helps to stimulate colon movement and improve constipation. Promote scientific and regular life, work and rest on time, and establish the habit of regular bowel movement. If poor mental status and physical discomfort are detected, patients should go to the hospital as soon as possible. Treatment should be individualized according to the patient’s specific situation, and the trigger should be actively sought and eliminated to reduce symptoms. Since mental factors are the main trigger for the development of the disease, the treatment of patients should be comprehensive, specifically including psychotherapy, biofeedback therapy and various medications. In particular, depression and anxiety should be actively controlled to improve insomnia, and the drugs available are paroxetine, venlafaxine, mirtazapine, tandospirone citrate, lorazepam, zopiclone, etc. For gastrointestinal symptoms, drugs such as loperamide, domperidone (morpholine), cisapride, etc., which promote gastrointestinal activity, dimethicone oil, medicinal charcoal (activated charcoal), etc., which eliminate flatulence in the gastrointestinal tract, probenecid, scopolamine, tegaserod, etc., which relieve spasm and pain in the stomach and intestines, and lactulose, etc., which improve constipation, can be used. With the correction of the gastrointestinal dysfunction, most patients will be significantly relieved or get better. At the end of this article, we present the treatment of a patient with abnormal bowel habits caused by anxiety. The patient, male, 48 years old, was a professional driver of a large state-owned enterprise. He presented to the clinic with complaints of ideological tension with abdominal distension and severe abnormal bowel habits for 2 years. The patient was driving for the main leader of the unit, and his mind was under long-term tension, and he needed to be on call 24 hours a day because of his work, so he gradually developed gastrointestinal dysfunction. He was nervous when he heard a phone call, and his abdomen immediately became distended and painful and he needed to go to the toilet immediately, which eventually developed to several times a day, regardless of the occasion. In the long run, this led to fear of eating and drinking, lack of energy, insomnia and dreaminess at night, and short temper, which seriously interfered with normal work and life. He had suspected that he had an incurable disease, and after several examinations showed no abnormality, and he had used a lot of digestive drugs to no avail, he then went to the neurology department. After related examination and condition analysis, he was finally diagnosed with irritable bowel syndrome, and was given paroxetine, tandospirone citrate, lorazepam, mosapride and other drugs for comprehensive management. After six months, his symptoms basically improved, and he was once again full of energy to work.