Disordini funzionali intestinali: Ottimizzare la gestione diagnostica e terapeutica nella pratica del medico di medicina generale

Translated title of the contribution: Functional intestinal disorders: How to improve diagnosis and treatment in the general practice

N. Caporaso, F. Morisco, R. Penagini

Research output: Contribution to journalArticlepeer-review

Abstract

The general practitioner is most likely to benefit from this "Opinion Paper" about the functional intestinal disorders, both as an update and as a tool to improve his/her relationship with patients. Four functional intestinal disorders have been described: irritable bowel syndrome, functional bloating, functional constipation and functional diarrhea. All such disorders are defined by non-specific symptoms, referred to the middle and/or lower gastrointestinal tract without evidence of any organic basis. Symptoms should have arisen at least six months earlier, and they should have recurred at least three times monthly over the last three months. Disorders of motility, visceral hypersensitivity, inflammatory and immune disorders, as well as psycho-social, genetic and environmental factors, have all been involved in the pathophysiology of functional intestinal disorders; disturbances of the colonic bacterial flora are also suggested to have a leading role and interventions to correct them are most useful. Functional intestinal disorders as described in uie validated Rome III Criteria are possibly too much categorized, but such criteria still are the only useful tool for diagnosis and therapeutic choices. Clinical history is crucial for diagnosis, meaning when symptoms were first detected and how they evolve, alternate, and associate. A diagnostic diary to report symptoms, daily activities, and foods may also be helpful. Functional intestinal disorders persist over time, and they heavily interfere with quality of life; they also have a heavy impact on economical resources. However, intestinal functional disorders are not associated with dangerous sequelae or mortality. It is up to general practitioners to reassure patients and to prescribe first-level diagnostic exams appropriately.

Translated title of the contributionFunctional intestinal disorders: How to improve diagnosis and treatment in the general practice
Original languageItalian
Pages (from-to)101-120
Number of pages20
JournalMinerva Gastroenterologica e Dietologica
Volume56
Issue number2
Publication statusPublished - Jun 2010

ASJC Scopus subject areas

  • Gastroenterology
  • Internal Medicine
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism

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