The complex interrelationship between the mind and the bowels has baffled physicians for several hundred years. In 1816, the German physician, G. L. Hohnstock described a bowel-obsessed patient with chronic symptoms of constipation, diarrhea and abdominal pain typical of modern-day irritable bowel syndrome (IBS). Hohnstock wrote, “he directs his attention very specifically to his B.M.’s because what agony and anxiety constipation cause him. Whenever the subject comes around to constipation socially, he perceives again these hypochondriacal complaints. He is happy to spend long sessions upon the toilet. To extend his stay he lays in a supply of books. Also, he takes purgatives to combat constipation, and any doctor can insinuate himself with [the patient] who is willing to prescribe them…. The hypochondriac now believes that life is impossible without laxatives, and if none are available, he gives himself an enema. He also pays quite exact notice to his stool and its composition, keeps a diary of it in which he records daily with great exactness the quantity and quality of the excrement” [36]. Although Dr. Hohnstock’s patient may have been a hypochondriac with psychogenic symptoms, he also had a clear gut motility disorder.
Robert W. Baloh Medically Unexplained Symptoms A Brain-Centered Approach
