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Intestinal and extraintestinal symptoms in functional gastrointestinal disorders
E A Mayer1, R Fass, S Fullerton
1UCLA/CURE Neuroenteric Disease Program, UCLA School of Medicine, Los Angeles, CA 90073, USA. emayer@ucla.edu
The European Journal of Surgery. Supplement. : = Acta Chirurgica. Supplement
|February 23, 1999
Summary
Functional gastrointestinal disorders extend beyond the gut, affecting sleep, energy, and pain perception. Emerging models suggest these conditions involve complex interactions between the nervous, visceral, and musculoskeletal systems.
Area of Science:
- Gastroenterology and Neuroscience
Background:
- Functional gastrointestinal disorders (FGIDs) like irritable bowel syndrome were traditionally viewed as isolated digestive issues.
- Clinical evidence increasingly links FGIDs to a broader spectrum of physical symptoms and vital function alterations.
Purpose of the Study:
- To explore the expanding understanding of FGIDs beyond the digestive system.
- To examine the connection between FGIDs and extraintestinal symptoms within a comprehensive disease model.
Main Methods:
- Review of clinical experience and published evidence on FGIDs and associated symptoms.
- Analysis of proposed pathophysiological mechanisms involving nervous system, visceral, and musculoskeletal interactions.
Main Results:
- Patients with FGIDs frequently report symptoms like fibromyalgia and irritable bladder.
- Alterations in sleep, libido, appetite, and energy levels are common in FGID patients.
- A comprehensive model suggests FGIDs stem from dysregulated interactions between the nervous, visceral, and musculoskeletal systems.
Conclusions:
- FGIDs are complex conditions with significant extraintestinal manifestations.
- Central nervous system alterations (arousal, attention, fear circuits) and hypothalamic pituitary adrenal (HPA) axis dysfunction may contribute to the symptom burden.
- A holistic approach is needed to understand and manage the multifaceted nature of FGIDs.