Overview of functional gut disorders: a challenge

Area of Science:

• Clinical Medicine
• Gastroenterology
• Psychosomatic Medicine

Background:

• The term 'functional disorder' has dual meanings: demonstrable functional impairment or unexplained chronic symptoms.
• A broader view integrates illness and disease, acknowledging symptom-behavioral discrepancies.
• Reconciling these definitions is crucial for comprehensive patient care.

Purpose of the Study:

• To explore the multifaceted nature of functional disorders.
• To integrate biomedical and psychosocial aspects in understanding functional gut disorders.
• To illustrate these concepts using gastroesophageal reflux disease (GERD) as a model.

Main Methods:

• Conceptual analysis of the term 'functional disorder'.
• Discussion of the brain-gut axis in pathophysiology.
• Case illustration using gastroesophageal reflux disease.

Main Results:

• Functional disorders encompass both objective functional deficits and subjective symptom complexes.
• Psychosocial and cognitive-behavioral factors significantly influence gut function via the brain-gut axis.
• GERD pathophysiology and patient behavior are influenced by these integrated factors.

Conclusions:

• A unified approach is needed to manage functional disorders, considering both physiological and psychological dimensions.
• The brain-gut axis provides a framework for understanding the interplay of factors in functional gut disorders.
• Integrated management strategies addressing motor, sensory, psychosocial, and cognitive-behavioral aspects are essential.