[Functional Exams in the gastroenterology - new developments and tips for the common practice]

Area of Science:

• Gastroenterology
• Digestive Health
• Medical Diagnostics

Background:

• Functional gastrointestinal disorders (FGIDs) present a significant public health challenge due to their high prevalence and associated healthcare costs.
• Accurate diagnosis of FGIDs often relies on specialized functional tests, which have seen reduced utilization during the COVID-19 pandemic.
• Despite challenges, essential diagnostic procedures are necessary for identifying serious conditions like achalasia.

Purpose of the Study:

• To review recent advancements in the diagnosis and management of functional gastrointestinal disorders.
• To highlight the importance of high-resolution manometry (HRM) in diagnosing esophageal conditions.
• To discuss the association between intestinal methanogen overgrowth (IMO) and irritable bowel syndrome (IBS).

Main Methods:

• Review of current literature and guidelines on FGID diagnostics.
• Focus on high-resolution manometry (HRM) for esophageal motility disorders.
• Discussion of H2-Breath Tests for diagnosing intestinal methanogen overgrowth (IMO).

Main Results:

• High-resolution manometry (HRM) remains the gold standard for diagnosing achalasia.
• New European guidelines offer a safe approach to pneumatic dilatation for achalasia.
• Intestinal methanogen overgrowth (IMO), linked to Methanobrevibacter smithii, may be associated with irritable bowel syndrome (IBS) in some patients.

Conclusions:

• Advancements in diagnostic techniques are vital for managing FGIDs effectively.
• Safe and standardized procedures for conditions like achalasia are being refined.
• Further research into IMO and its link to IBS is warranted.