Functional gastrointestinal diseases (FGIDs) are very common in digestive clinics. Due to their persistent, prolonged and overlapping symptoms, FGids often seriously affect patients' study, work, life, mental health and quality of life. Early IDENTIFICATION OF FUNCTIONAL gastrointestinal diseases AND their subTYPES, effective intervention, and accurate differentiation from organic diseases are the key to improve the curative effect, improve the quality of life of patients, and prevent misdiagnosis and misuse of treatment. With the promulgation of Roman IV diagnostic criteria, people have a more comprehensive understanding of functional gastrointestinal diseases.
What is functional gastrointestinal disease?
Functional gastrointestinal diseases (FGIDs) are a group of functional gastrointestinal diseases, which are caused by the interaction of physiological, environmental, psychological and social factors. Fgids are not uncommon in clinical patients, accounting for 50% to 70% of the outpatient visits in gastroenterology department.
Studies have examined the incidence of FGID and the cumulative effect of health damage in the general population of multiple countries according to the Rome IV diagnostic criteria. Of the 6,300 adult volunteers in the study, 5,931 completed the survey. The study found that 2,083 people (35%) had symptoms of FGID, and 36% of those with symptoms had multiple symptoms. People with multiple symptoms have poor mental and physical status, poor quality of life, need drug treatment and increased risk of abdominal surgery. The quality of life score of patients with multisymptom functional gastroenteropathy is significantly lower than that of patients with organic gastrointestinal diseases.
What are the types of functional gastroenteropathy in Rome IV?
According to Rome IV criteria, FGIDs are divided into three major groups according to symptom area and characteristics: Functional esophageal diseases (including functional heartburn, esophagogenic functional chest pain, functional dysphagia, globus hysteria), functional gastroduodenopathy (including functional dyspepsia, belching, nausea and vomiting, ruminant syndrome) , functional bowel disease (including irritable bowel syndrome, functional bloating, functional constipation, functional diarrhea, non-specific functional bowel disease).
The new diagnostic system also adds anaesthetic intestinal syndrome/opioid induced gastrointestinal hyperalgesia, central mediated abdominal pain syndrome, opioid induced constipation, cannabinoid hyperemesis syndrome, etc. These conditions differ from other FGIDs in that they have a causal factor (opioids and cannabinoids) that can be removed to normalize.
What factors contribute to functional gastrointestinal disease?
For FGIDs, the clinical features cannot be explained by organic diseases. Currently, FGids are described as brain-gut interaction disorders. The pathogenesis of FGids is understood in a 'bio-psycho-social' model, and the conceptual understanding of FGids has been transformed from biomedical reductionism to a more holistic bio-psycho-social model. There are many reasons for its onset, such as gastrointestinal motility disorder, intestinal microbiota disorder, mucosal immune dysfunction, visceral hypersensitivity, diet and other factors interaction, resulting in various clinical symptoms.
In our country, functional gastrointestinal diseases in adults are commonly characterized by functional dyspepsia (FD), functional constipation (FC) and irritable bowel syndrome (IBS). Patients with FGIDs also often present with extragastrointestinal symptoms, such as dyspnea, palpation, chronic headache, and myalgia. Psychiatric disorders are also common in patients with FGIDs, especially those with severe or persistent symptoms, with an incidence of 42% to 61%. In functional dyspepsia, for example, the early clinical manifestation is not typical, may be characterized by irregular symptoms such as abdominal distension, belching, early enough, adjust the diet may ease gradually, but if not handled in time, patients with recurrent may affect study, work, life, if not timely diagnosis and treatment of recurrent symptoms may induce or aggravate tension and anxiety of patients, Thus further aggravating the somatic symptoms.
Taking functional dyspepsia (FD) as an example, the prevalence of FD among healthy adults (15-75 years old) in China is 23.5%, with an average of more than 1 in 5 people having FD. FD is a group of chronic and fluctuating symptoms, the main symptoms include postprandish fullness, early satiety, belching, loss of appetite, nausea and vomiting, upper abdominal pain, and often overlap with other upper or lower gastrointestinal symptoms.
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Functional gastroenteropathy (FGIDs) is a group of clinical syndromes with unclear etiology and pathophysiology. Most of the patients seek medical treatment from place to place. To meet the new needs for FGIDs diagnosis and treatment, Kuangcheng Technology has successfully developed a multifunctional biofeedback gastrointestinal motility instrument, which integrates an electrical detection and analysis system for gastrointestinal diseases and a functional gastrointestinal disease treatment system to eliminate or reduce the symptoms of patients without medication.