天津医科大学内科学课件 Functional Gastrointestinal Disorders.pptVIP

* the exact pathogenesis of FD still remain poorly understood so far. But the major pathophysiological mechanisms responsible for functional dyspepsia include psychosocial factors and alterations in motility and visceral sensation. * the exact pathogenesis of FD still remain poorly understood so far. But the major pathophysiological mechanisms responsible for functional dyspepsia include psychosocial factors and alterations in motility and visceral sensation. Pharmacological therapies Drug therapy for IBS can be considered in two categories: 1.End organ treatment aimed at relieving abdominal pain (antispasmodic drugs) or disturbed bowel habit (antidiarrhoeal and bulking agents).  2. Central treatment (antidepressants) targeted at patients with associated affective disorder.  Possible drugs for a dominant symptom in IBS Functional gastrointestinal disorders Rome Committees: multinational working teams Rome Criteria Symptom-based diagnostic criteria: Rome I 1994 Rome II 1999 Rome III 2006 ? Definition of FGID Chronic and recurrent symptoms of the gastrointestinal (GI) tract, such as pain, nausea, vomiting, bloating, diarrhea, constipation, without detectable structural or biochemical abnormalities. FGIDs are classified into six major domains for adults (anatomic region) Esophageal (categry A) Gastroduodenal (categry B) Bowel (categry C) Functional abdominal pain syndrome (categry D) Biliary (categry E) Anorectal (categry F) Functional Esophageal Functional Abdominal Pain Functional Billiary Functional Anorectal Functional Gastroduodenal IBS Functional Bowel Rome III Diagnostic Classification Each category site contains several disorders, each having relatively specific clinical features FGID - Conceptual Model Physiology Motility Sensation Inflammation Altered bacterial flora FGID Symptoms Behavior Brain CNS Gut ENS Psychosocial Factors LIfe stress Psychologic state Coping Social support Early Life Gen