Early diagnosis and the optimal control of inflammation, with a continuous cycle of assessment, treatment, monitoring, and adjustment of therapy, is best practice for the management of inflammatory bowel disease. However, patients express frustration with ongoing challenging symptoms, often discordant with inflammation, including abdominal pain, fatigue, depression, anxiety, and emotional wellness; these are often not optimally addressed by inflammatory bowel disease clinicians due to lack of time or resources. This review will highlight the burden of these symptoms and issues, suggest ways of assessing these in clinical practice, highlight the importance of acknowledging and validating the symptoms and issues with patients, reassuring them that they are being heard, and discuss different possible models of service delivery for psychosocial support, from fully integrated gastropsychology models to referral pathways that optimize community support. We suggest the importance of the treat-to-target concept, where the target is not only control of inflammation but also emotional wellness.

早期诊断和炎症的最佳控制，以及评估、治疗、监测和调整治疗的连续循环，是炎症性肠病管理的最佳实践。然而，患者对持续存在的具有挑战性的症状表示沮丧，这些症状通常与炎症不一致，包括腹痛、疲劳、抑郁、焦虑和情绪健康；由于缺乏时间或资源，炎症性肠病临床医生通常无法最佳解决这些问题。这篇综述将强调这些症状和问题的负担，提出在临床实践中评估这些问题的方法，强调承认和验证患者症状和问题的重要性，让他们放心，他们正在被倾听，并讨论提供社会心理支持的不同服务模式，从完全整合的胃心理学模式到优化社区支持的转诊途径。我们建议治疗目标概念的重要性，其中目标不仅是控制炎症，而且是情绪健康。