Table 1.

Suggested Approaches When Caring for Patients With Chronic Abdominal Pain and Other Functional Gastrointestinal Disorders

Goal	Prefer	Avoid
Express empathy	Acknowledge patient suffering (eg, “I am sorry you feel this way…I can see that the pain has really affected your life. I will do my best to help you.”)	Dismissing symptoms (eg, “There is nothing wrong with you.”)
Assess the patient’s insight into the functional nature of the pain	Ask open-ended questions (eg, “Can you tell me what you think is causing your symptoms?” or “Tell me about what concerns you the most about your symptoms.”)	Closed-ended questions (eg, “Do you think your pain is caused by eating?”)
Understand the patient’s expectation from the physician	Ask open-ended questions (eg, “Tell me a little about what you were expecting from this consultation” or “I see that you have been suffering from pain for many years. Could you tell me a little bit about what made you come to see me today?”)	Judgmental statements (eg, “I am not sure I can help you. You have been to so many doctors already.”)
Understand the patient’s expectations from treatment(s)	Ask probing, open-ended questions (eg, “If I asked you what would be a reasonably tolerable pain level that we can try to achieve, what would you say?”)	Imposing a treatment plan (eg, “My plan is to refer you to the psychiatrist and the pain specialist.”)
Assess the patient’s understanding of education provided by the physician	“I provided you with quite a bit of information today and want to make sure you understood what I said. Can you tell me what you have understood so far?”	Unilateral flow of information (eg, “I hope you understood all the things we discussed today and implement the suggestions I gave you.”)
Help the patient take responsibility for the illness	Suggest that the patient keep a diary of symptoms for 3–4 wk	Prescribing treatments in which the patient is a passive recipient