Functional Gut Disorders

More than half of the patients in a gastroenterological clinic complain of abdominal symptoms, without demonstrable cause by conventional diagnostic tests. In the absence of positive findings, unexplained abdominal symptoms have been categorized as functional gastrointestinal disorders, and several syndromes, such as noncardiac chest pain, functional dyspepsia, and the irritable bowel syndrome (IBS), have been defined. Non-cardiac chest pain refers to patients with thoracic symptoms without cardiac, pulmonary, or esophageal disorders. Functional dyspepsia applies to symptoms such as epigastric pain, pressure, fullness, and bloating that presumably originate from the upper gastrointestinal tract, and that are frequently precipitated by meals. The IBS is attributable to the distal gut, and is characterized by abdominal pain or discomfort associated to disordered bowel habit. The diagnosis of those syndromes is solely based on clinical criteria, because their underlying pathophysiology has not yet been unestablished. It is noteworthy that similar types of functional syndromes have also been described in urology (interstitial cystitis), gynecology (some forms of chronic pelvic pain), and the musculos-keletal system (fibromyalgia). Some data suggest that patients with different visceral functional disorders could have a sensory dysfunction, so that physiological stimuli that are normally unperceived, activate perception pathways and produce their symptoms. This concept has attracted much attention in the field of visceral sensitivity.

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