
- With Mayo Clinic gastroenterologist
Michael F. Picco, M.D.
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Michael F. Picco, M.D.
Michael F. Picco, M.D.
Dr. Michael Picco has been with Mayo Clinic since 1999. He is board certified in internal medicine and gastroenterology. Dr. Picco is an assistant professor of medicine at College of Medicine, Mayo Clinic, and a consultant in gastroenterology at Mayo Clinic in Florida.
He has authored numerous publications in the area of gastroenterology, including original research, editorials and textbook chapters. He works with a team of gastroenterologists that takes care of complex gastrointestinal conditions and has a particular interest in diarrheal illnesses and inflammatory bowel diseases (ulcerative colitis and Crohn's disease). He is also active in medical education in training new gastroenterologist and internists.
"Mayo Clinic's website is an invaluable resource for patients and their families," Dr. Picco said. "Informed patients are better able to participate in their own health care. A patient's participation is vital to the treatment of his or her disease. I hope to assist in helping patients understand their digestive problems and current treatments that are offered. This will allow for better communication between patients, their physicians and other health care professionals."
Dr. Picco serves as a reviewer of new research for several medical journals in the area of gastroenterology and is an active member of the American Gastroenterological Association, American College of Gastroenterology and the Crohn's & Colitis Foundation of America. He serves on numerous committees that address physician training, research and clinical practice in gastroenterology, both at Mayo Clinic and at the national level.
"Patients need to know about their disease, what to expect, the latest treatments and side effects so that they can make informed decisions about their health care. Gastrointestinal disease affects not only patients but also their families. My goal is to assure that our website provides accurate, reliable information and resources for patients. We must always provide the latest, most cutting-edge information to assist patients in dealing with their medical problems," Dr. Picco said.
Question
Nervous stomach: Is there such a thing?
Is there such a thing as a nervous stomach? I've been told that I have one.
Answer
from Michael F. Picco, M.D.
Nervous stomach is an old-fashioned term for chronic indigestion. The idea of having a nervous organ could be a holdover from about 100 years ago, when a syndrome called nervous exhaustion or neurasthenia — thought to be caused by "nerve irritation" — was a fairly common diagnosis. The typical treatment was a long period of rest.
Today, it would be unusual for a doctor to say you have a nervous stomach. That said, your nervous system can definitely affect your digestion. In fact, some functions of your nervous and digestive systems are so interdependent that they're thought of as a unit — the brain-gut axis. Your digestive tract also has its own separate nervous system, known as the enteric nervous system, which operates independently of your brain to regulate certain aspects of digestion.
The brain-gut axis could be involved in the chronic digestive problems known as functional gastrointestinal disorders, including irritable bowel syndrome, functional dyspepsia, and functional abdominal pain. These conditions aren't the result of a structural abnormality or infection in your gastrointestinal tract, but they can take a serious toll on your quality of life.
If you have a recurrent digestive problem, tell your doctor what it is — stomach pain, heartburn, bloating, diarrhea or several symptoms at different times. You'll also need a physical examination, possibly followed by tests to diagnose or rule out an ulcer, gallstones or any other specific disease your symptoms suggest.
This workup may not identify a specific abnormality. If you're otherwise healthy, though, further testing is usually unnecessary. Instead, your doctor may suggest that you keep a symptom record and track your diet, mealtimes, stress levels and other variables that may be triggering your problems. This record may highlight a few simple changes you can make to reduce the frequency of your symptoms. A combination of lifestyle adjustment, medication and behavioral treatment usually brings functional gastrointestinal disorders under control.
- Shorter E. From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. New York, N.Y.: The Free Press; 1992.
- Beard GM. A Practical Treatise on Nervous Exhaustion (Neurasthenia): Its Symptoms, Nature, Sequences, Treatment. New York, N.Y.: William Wood & Company; 1880.
- Gaman A, et al. Neuromodulatory processes of the brain-gut axis. Neuromodulation. 2008;11:249.
- Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377.


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