Journal
CLINICAL MEDICINE
Volume 21, Issue 1, Pages 44-52Publisher
ROY COLL PHYS LONDON EDITORIAL OFFICE
DOI: 10.7861/clinmed.2020-0980
Keywords
gastrointestinal; irritable bowel syndrome; functional dyspepsia; functional disorders; pain
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Functional GI disorders, such as irritable bowel syndrome and functional dyspepsia, are common conditions that significantly impact quality of life and healthcare utilization. These disorders are caused by abnormalities in GI functioning. Treatment involves lifestyle and diet modifications, addressing psychological comorbidity, and medication to target underlying pathophysiology.
Functional gastrointestinal (GI) disorders (eg irritable bowel syndrome and functional dyspepsia) are very common conditions which are associated with very poor quality of life and high healthcare utilisation. They are caused by disorders of GI functioning, namely altered gut sensitivity, motility, microbiota, immune functioning and central nervous system processing. They cause chronic symptoms throughout the gut (eg pain, dyspepsia and altered bowel habit), all of which are made worse by maladaptive patient behaviours, stress and psychological comorbidity. Management involves a biopsychosocial approach involving changes in lifestyle and diet, addressing coexisting psychological comorbidity and using medication to treat underlying pathophysiology. Pharmacological treatment with antispasmodics, neuromodulators, motility agents and antidepressants is effective. Psychotherapy in motivated individuals is equally effective. Success of treatment is increased by a good doctor-patient relationship and so this needs to be taken into account during the consultation.
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