Disorders of gut-brain interaction, previously called functional gastrointestinal disorders, are prevalent, disabling, expensive, and difficult to treat. In this review, I trace the available scientific knowledge on the pathophysiology of these disorders and describe how the proposed pathways are integrated into treatment approaches. A novel treatment approach, heart rate variability biofeedback (HRVB), is described, and outcome literature is reviewed. It is concluded that an approach such as HRVB offers benefits beyond more traditional treatment approaches.