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Functional Gastrointestinal Disorders Uncategorized

Functional Gastrointestinal Disorders

The causes of functional symptoms are obscure. There is some evidence that such patients have a visceral hypersensitivity, a disorder of pain sensation, in which they perceive sensations (z. B. Expansion of the intestinal lumen, peristalsis) as painful, do not consider the other patients as unpleasant. In some patients psychological causes such as anxiety exist (with or without Aerophagia), conversion disorders, body symptom disorder ( “somatic symptom disorder”) or illness anxiety disorder ( “illness anxiety disorder”) (formerly hypochondria) that are associated with gastrointestinal symptoms. Psychological theories are that functional symptoms can satisfy certain psychological needs; so some patients of their disease have secondary gain. In these patients, successful treatment of symptoms can lead to the development of other symptoms.

In a number of cases, no physiological causes for the explanation of gastrointestinal complaints are found even after intensive investigation. The diagnosis of these patients is then “functional disorders”, which account for 30-50% of patients at the gastroenterologist. Functional disorders can manifest themselves in the upper and / or lower GIT. The causes of functional symptoms are obscure. There is some evidence that such patients have a visceral hypersensitivity, a disorder of pain sensation, in which they perceive sensations (z. B. Expansion of the intestinal lumen, peristalsis) as painful, do not consider the other patients as unpleasant. In some patients psychological causes such as anxiety exist (with or without Aerophagia), conversion disorders, body symptom disorder ( “somatic symptom disorder”) or illness anxiety disorder ( “illness anxiety disorder”) (formerly hypochondria) that are associated with gastrointestinal symptoms. Psychological theories are that functional symptoms can satisfy certain psychological needs; so some patients of their disease have secondary gain. In these patients, successful treatment of symptoms can lead to the development of other symptoms. Many referring physicians and gastroenterologists have difficulty understanding functional gastrointestinal disorders and to explain, and this uncertainty leads to frustration and preconceptions. With insistent patients with unexplained symptoms, physicians should avoid repeated conduct investigations or to try multiple drugs. If the symptoms do not indicate a serious disease, the doctor should wait and not implement another diagnostic or therapeutic plan. Over time, new information may lead the evaluation and management. Functional complaints are made sometimes in patients with physiological problems (eg, peptic ulcer, esophagitis.); these symptoms do not regress, even though the physical illness is treated. In some patients (eg., CT) are made incidental findings from the investigations that are not related to the symptoms.

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