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Medical Evaluation of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Michael Camilleri, Jeffrey W. Frank
Several symptoms may be attributable to functional gastrointestinal disorders, including dysphagia, odynophagia, chest pain, heartburn, nausea, vomiting, early satiety, bloating, abdominal pain, constipation, diarrhea, and incontinence. These symptoms arise from different regions of the digestive tract, including the esophagus, stomach, small bowel, colon, and anorectum. In general, most patients with these syndromes have a normal life expectancy, but there is considerable morbidity, depending on the severity of the symptoms or syndrome in the individual patient
Anxiety, Depression, and Somatization in Irritable Bowel Syndrome
Published in Peter Manu, The Psychopathology of Functional Somatic Syndromes, 2020
These data show that the vast majority of patients with irritable bowel syndrome and their first-degree relatives have a past history of depressive and anxiety syndromes, but only one in four patients suffers from an active mood disorder. Moreover, the severity of functional gastrointestinal disorder does not correlate with the presence of depression or anxiety, but is linked to the magnitude of the somatization phenomena expressed by these patients. In turn, the severity of somatization predicts the burden of psychopathology and the overall psychological distress experienced in irritable bowel syndrome.
Kampo Medicine: A Different Model for Integrating Health Care Practices
Published in David R. Katerere, Wendy Applequist, Oluwaseyi M. Aboyade, Chamunorwa Togo, Traditional and Indigenous Knowledge for the Modern Era, 2019
If patients have anorexia, nausea, vomiting, and heartburn originating in the upper digestive tract, and malignant tumor and peptic ulcer are ruled out in the diagnosis, these symptoms often indicate a functional gastrointestinal disorder such as functional dyspepsia. Functional gastrointestinal disorders are complex pathologic conditions. Western medicine having a singular site or mechanism of action is often not completely effective. For such pathologic conditions, Kampo medicines considered to have multiple sites of action are as effective as, or more effective than, Western therapies.
The duodenal mucosa associated microbiome, visceral sensory function, immune activation and psychological comorbidities in functional gastrointestinal disorders with and without self-reported non-celiac wheat sensitivity
Published in Gut Microbes, 2022
Ayesha Shah, Seungha Kang, Nicholas J Talley, Anh Do, Marjorie M Walker, Erin R Shanahan, Natasha A Koloski, Michael P Jones, Simon Keely, Mark Morrison, Gerald J Holtmann
Patients presenting with chronic or relapsing gastrointestinal symptoms that are not explained by structural or biochemical abnormalities as the cause of symptoms are referred to as patients with functional gastrointestinal disorders (FGID).1,2 Utilizing the Rome Criteria, these patients are categorized based upon their gastrointestinal symptoms into discrete disorders such as irritable bowel syndrome (IBS) or functional dyspepsia (FD).1 However, the heterogeneity of these conditions with regard to symptoms and potential triggers of symptoms suggests that within these disorders, there are distinct sub-clinical pathophysiologies.2 In recent years, it has been recognized that a considerable proportion of these patients with FGID report symptoms that are triggered or aggravated by the consumption of wheat products and that symptoms improve when wheat containing foods are avoided, even though celiac disease has been excluded. These FGID patients with intolerance of wheat products – without celiac disease as the cause of symptoms – are now frequently referred to as patients with self-reported non-celiac wheat sensitivity (SR-NCWS).3
Gut microbiota-motility interregulation: insights from in vivo, ex vivo and in silico studies
Published in Gut Microbes, 2022
Barbora Waclawiková, Agnese Codutti, Karen Alim, Sahar El Aidy
Understanding gut motility is fundamental when addressing functional gastrointestinal disorders, including inflammatory bowel disease and constipation. A large-scale multinational study revealed that more than 40% of the population worldwide suffer from functional gastrointestinal disorders, which, consequently, have a negative impact on the quality of life and health care use1. Gastrointestinal motility is a key physiological parameter that governs digestion and absorption of nutrients, and is regulated by various factors, such as the enteric nervous system, immune system, gut hormones, as well as gut microbes.2–4 Nonetheless, the mechanisms that govern the complex and dynamic interrelationships between these factors remain unclear. To date, reports on the mechanisms underlying gut motility typically comes from three types of research methodologies; 1) in vivo investigations, including human or animal studies,4–7 2) in vitro/ex vivo experiments, which involve cell/organ culture, and organ bath studies,4,5,8 and 3) in silico models, which employ simulations and computational methods in an attempt to cover different aspects of interactions between motility, flow, transport, bacteria, and their metabolites. This review summarizes current literature available on the impact of the microbiota on gut motility and describes how in silico studies can be designed to complement the existing methods to allow deciphering the mechanisms underlying the microbiota-gut motility interplay.
Intragastric fructose administration interacts with emotional state in homeostatic and hedonic brain regions
Published in Nutritional Neuroscience, 2022
Julie Iven, Jessica R. Biesiekierski, Dongxing Zhao, Jan Tack, Lukas Van Oudenhove
This study is the first to indicate that fructose and emotional context interact in homeostatic and hedonic brain regions without a conscious perception of these neural responses. Our findings show that a neurohumoral gut-brain pathway could explain appetite disturbances in mood disorders or emotional overeating in healthy subjects, as a decrease in neural reward responses to fructose administration during the sad emotional context was observed. Likewise, an interactive effect of fructose infusion and emotional context on circulating GLP-1 levels was observed, together with increased levels of ghrelin during the sad state, regardless of the nutrient administration. Applying a similar study design in patients with functional gastrointestinal disorders, affective disorders, or food intake disorders, where a comorbidity between gastrointestinal and psychological symptoms exists [37], might be of interest.