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[Functional gastrointestinal diseases].

J Keller1, P Layer

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Summary
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Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common functional gastrointestinal diseases affecting up to 15% of the German population. Diagnosis involves symptom patterns, excluding alarm signs, and normal endoscopic evaluations, with treatment tailored to dominant symptoms.

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Clinical Research

Context:

  • Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are prevalent functional gastrointestinal diseases (FGID).
  • These conditions affect approximately 5-15% of the German population.
  • Symptoms stem from disturbances in gastrointestinal motility, secretion, sensitivity, and central processing of visceral afferences.

Purpose:

  • To outline the diagnostic criteria and management principles for FD and IBS.
  • To emphasize the role of psychosocial factors in disease course and symptom perception.
  • To guide clinicians in the diagnosis and treatment of these common FGIDs.

Summary:

  • Diagnosis relies on characteristic symptoms, absence of alarm features, and exclusion of organic diseases.
  • FD diagnosis requires a normal upper GI endoscopy; IBS diagnosis, per current German guidelines, necessitates a normal colonoscopy.
  • Initial management includes patient education on the condition's benign nature and identification/elimination of trigger factors.
  • Pharmacological treatment for persistent symptoms is guided by the predominant clinical presentation.

Impact:

  • Provides a concise overview of current diagnostic and therapeutic approaches for FD and IBS in Germany.
  • Highlights the importance of a systematic diagnostic process, including endoscopic evaluations.
  • Emphasizes a patient-centered approach to management, addressing both physiological and psychosocial aspects.