Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview

Holtmann, Gerald, Shah, Ayesha and Morrison, Mark (2018) Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview. Digestive Diseases (Basel, Switzerland), 35 5-13. doi:10.1159/000485409

Author Holtmann, Gerald
Shah, Ayesha
Morrison, Mark
Title Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview
Journal name Digestive Diseases (Basel, Switzerland)   Check publisher's open access policy
ISSN 1421-9875
Publication date 2018-02-08
Year available 2018
Sub-type Article (original research)
DOI 10.1159/000485409
Open Access Status DOI
Volume 35
Start page 5
End page 13
Total pages 9
Place of publication Basel, Switzerland
Publisher S. Karger
Abstract Background and Summary: Traditionally, functional gastrointestinal disorders (FGID), including functional dyspepsia or irritable bowel syndrome (IBS), are defined by more or less specific symptoms and the absence of structural or biochemical abnormalities that cause these symptoms. This concept is now considered to be outdated; if appropriate tests are applied, structural or biochemical abnormalities that explain or cause the symptoms may be found in many patients. Another feature of FGID are the highly prevalent psychiatric comorbidities, such as depression and anxiety. It is implied that mood disorders "cause" gastrointestinal symptoms. In fact, epidemiological data now provide strong evidence that in subsets of cases, gastrointestinal (GI) symptoms arise first and mood disorders occur later, while in other patients the reverse appears to happen. Possible mechanisms for gut-brain dysfunction have been identified, with systemic minimal inflammation as a causal factor in at least some subjects. Other mechanisms that play a role in FGID include chronic infections, intestinal microbiota, low-grade mucosal inflammation including the increase of eosinophils, systemic immune activation, altered intestinal permeability, in diarrhea predominant IBS altered bile salt metabolism, abnormalities in the serotonin metabolism and genetic factors. All these factors might be modulated by environmental factors such as diet. Key Messages: While a number of factors can be linked to specific symptoms (e.g., pain or diarrhea), it is evident that the symptom-based categorization of patients will not allow targeted treatments that specifically address the underlying pathophysiology.
Keyword Brain-gut axis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Faculty of Medicine
UQ Diamantina Institute Publications
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Created: Wed, 14 Feb 2018, 11:04:56 EST