Integrating mind and gut: Dr. Megan Riehl on the future of GI psychology

As the science of the brain–gut connection continues to reshape how gastrointestinal disorders are understood and treated, few leaders have been more influential in advancing integrated psychological care than Megan Riehl, PsyD, AGAF. A nationally recognized expert at the intersection of psychology and gastroenterology, Dr. Riehl is an Associate Professor of Medicine and Clinical Director of the GI Behavioral Health Program at the University of Michigan. She also holds key leadership roles within Michigan Medicine focused on clinician wellbeing and serves on the national Board of Trustees for the Crohn’s & Colitis Foundation.

Dr. Riehl’s path into GI psychology was shaped early by her passion for integrated care and her interest in the bidirectional relationship between emotional and physical health. After specialized fellowship training at Northwestern — then the only program in the country offering GI behavioral health training within a Division of Gastroenterology — she went on to help build one of the nation’s leading GI Behavioral Health programs at Michigan. Today, she works as an embedded member of multidisciplinary GI teams, helping patients better understand their symptoms, build practical coping skills, and improve both outcomes and quality of life.

Beyond the clinic, Dr. Riehl is deeply committed to education, access, and community-building within the field. She is the co-author of the book Mind Your Gut: The Science-Based, Whole-Body Guide to Living Well with IBS co-host of The Gut Health Podcast, and a strong advocate for expanding training opportunities and insurance coverage for GI psychology services. In this month’s Member Spotlight, Dr. Riehl shares insights on the evolving role of GI psychologists, common misconceptions about the brain–gut connection, and why integrated psychological care is becoming an essential pillar of modern gastroenterology.

What first drew you to the intersection of psychology and gastroenterology, and how did that path shape your career?

Dr. Riehl: I was first drawn to behavioral health during my internship, where I provided mental health services to individuals seeking medical care at a community health center in Chicago. I quickly realized how much I enjoyed working as part of an integrated care team and having conversations about the bidirectional relationship between emotional and physical health.

That experience led me to pursue a fellowship at Northwestern, at the time the only program in the country offering specialized training in GI behavioral health within a Division of Gastroenterology.  Through what felt like a serendipitous path, I had the opportunity to receive training and mentorship from two leaders in the field, Drs. Laurie Keefer and Sarah Kinsinger, who helped support my early work and passion for this specialty. The enthusiasm and support of Dr. Bill Chey at the University of Michigan further inspired me to take an early-career leap to help build the GI Behavioral Health Program.

For readers who may be unfamiliar with the role, how does a GI-specific psychologist differ from a general mental health provider?

Dr. Riehl: GI psychologists are trained within gastroenterology settings to address disorders of gut–brain interaction and other digestive diseases using evidence-based brain–gut behavioral therapies. We work as integrated members of multidisciplinary GI teams to target symptom severity, treatment adherence, and quality of life by directly modulating brain–gut communication. At the same time, we often encourage patients to work with a general mental health provider for broader mental health needs, such as mood management, trauma, or eating disorders. Addressing these needs alongside GI-focused care ensures treatment is more effective and helps patients access the right type of support for their condition.

Why is integrated psychological care so critical for patients with gastrointestinal disorders, both in terms of outcomes and quality of life?

Dr. Riehl: Gastrointestinal disorders are inherently biopsychosocial, shaped by physiology, the nervous system, behavior, and lived experience. Integrated psychological care addresses these dimensions together rather than in isolation. When behavioral health is embedded within gastroenterology, patients better understand how symptoms, stress, and behaviors interact and learn strategies to manage symptoms and improve overall health. Integrated care also validates patients’ experiences and reduces stigma by framing psychological intervention as a core part of evidence-based GI treatment. By fostering a trusted, collaborative therapeutic team, we can intervene earlier, support patients through relapsing and remitting conditions, and improve both clinical outcomes and quality of life.

You’ve been a strong advocate for expanding access to GI psychology. What gaps do you still see in the field, and what needs to happen next?

Dr. Riehl: Education is truly my passion, and it drives much of my work — from my book and podcast to collaborations with digital health companies — all aimed at expanding access to the valuable care GI psychologists provide. While progress has been made, gaps remain. We need more training opportunities for the next generation of GI psychologists and earlier exposure for mental health providers to the diverse career paths within gastropsychology. Another major barrier is variability in insurance coverage for both GI psychology services and evidence-based digital products. Increasing coverage would greatly improve access to care and has the potential to reduce overall healthcare costs by improving symptom management and decreasing reliance on more invasive or costly interventions. Continued advocacy, education, and research will be essential to closing these gaps and moving the field forward.

As both a clinician and an author, how do you approach translating complex brain–gut science into practical, empowering guidance for patients?

Dr. Riehl: I start from the belief that patients don’t need less science; they need a better, more empathetic translation of it. I listen closely to how symptoms show up in daily life and what feels most confusing or discouraging to the patient. Then I reverse-engineer the science into clear, human language that explains why symptoms happen, without implying blame or inevitability.

I focus on three things: validation, mechanism, and agency. First, I validate that symptoms are real and biologically driven. Next, I explain the brain–gut mechanisms in simple, accurate terms — how the nervous system, immune signaling, and prior experiences shape gut function and pain. Finally, I translate that understanding into practical tools patients can use, emphasizing skills that restore a sense of control and safety in the body. The goal is to replace fear with understanding and helplessness with confidence, so patients feel informed, empowered, and active in their care rather than overwhelmed or stuck.

You’ve helped bring GI psychologists together through professional gatherings, including an upcoming meet up at AGA Central during Digestive Disease Week^® (DDW). Why is community-building within this specialty so important?

Dr. Riehl: For years, GI psychologists have often worked independently, developing programs within medical settings. While this independence allows for creativity and growth, it can also feel isolating. Networking with physician champions is important for building referral networks and multidisciplinary teams, but connection among GI psychologists is essential for professional growth, mentorship, and sponsorship. Time together also creates opportunities for collaboration in research and innovation, helping the field advance together. It’s always inspiring to reconnect with colleagues at DDW, hear about work happening around the world, and watch our meet up continue to grow.

Looking ahead, what excites you most about the future of GI psychology and its role in improving patient care?

Dr. Riehl: While a definitive medical diagnosis remains essential, GI psychologists are increasingly taking a central role in shaping patient care. More patients are seeking us out early, recognizing the importance of brain–gut behavioral therapies, and our evidence-based treatments are gaining visibility and credibility. I’m thrilled to see GI psychologists leading research and innovation that tackle the complexities of digestive diseases, while also being recognized in leadership roles to promote more holistic, integrated care. The field is evolving quickly, and it’s inspiring to watch how our work is improving outcomes, empowering patients, and creating new opportunities for collaboration. It’s an exciting time to be part of GI psychology!

Lightning round

Who inspires you and why?
People who actively seek joy, even in the midst of life’s challenges.

What are you excited about working on right now?
The Gut Health Podcast with Kate Scarlata.

Best piece of advice you’ve given or received?
Listen to your gut.

Favorite quote or words to live by?
You can do hard things, and you don’t have to do them alone.

What is your favorite GI organ and why?
The brain! It runs the show!

Favorite way to spend a day off?
An excellent cup of coffee, time outside, and a delicious meal with loved ones.

Best way to unwind after work?
Laughing with my kids and exercising.

Favorite AGA memory?
Any AGA Women in GI event!

If you could have dinner with anyone, who would it be and why?
The Obamas. They embody leadership, empathy, and vision.

What do you want to learn more about?
Brain–gut microbiome insights.

Favorite hobby?
Peloton.