Functional Gastrointestinal Disorders: Complex Treatments for Complex Pathophysiological Mechanisms

Mearin, Fermı́n; Malfertheiner, Peter

doi:10.1159/000485407

Cited by 24 publications

(22 citation statements)

References 16 publications

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“…Low incidence among our patients could have been due to multiple factors including a lower incidence of FGID in our population, small number of cases in this study or because our study is from a GI surgical clinic. Besides, since the diagnosis of FGID also depends on other factors including clinical suspicion [13] we may have underdiagnosed them in our patients.…”

Section: Organic Diseases and Alarm Symptomsmentioning

confidence: 97%

Burden of functional gastrointestinal disorders in a surgical clinic in Sri Lanka

Priyantha¹,

Tillakaratne

Kanchana

et al. 2020

Sri Lanka j Surg

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Section: Organic Diseases and Alarm Symptomsmentioning

confidence: 97%

Burden of functional gastrointestinal disorders in a surgical clinic in Sri Lanka

Priyantha¹,

Tillakaratne

Kanchana

et al. 2020

Sri Lanka j Surg

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“…10 In a large case-control study, the prevalence of any autoimmune condition was higher in subjects with FGIDs compared to controls without them, and the association persisted after controlling by age and gender, implying that the increased prevalence cannot be due to known associations of FGIDs. 7 In a recent large Australian population-based study, food allergies, psoriasis, and rheumatoid arthritis were independent risk factors for IBS after controlling for age, gender, and psychological distress. FGIDs/DGBI can co-exist not only with autoimmune diseases but also with other rheumatologic disorders.…”

Section: Introductionmentioning

confidence: 98%

“…FGIDs/DGBI have a significant negative impact on the health‐related quality of life (HRQL) in those affected, especially when co‐existing in patients with other organic disorders, and create a high social and economic burden . Despite this negative impact, the lack of a defined etiology limits therapies …”

Section: Introductionmentioning

confidence: 99%

“…Therefore, a link between FGIDs/DGBI such as functional dyspepsia, irritable bowel syndrome (IBS), functional constipation, and autoimmune disorders, including systemic lupus erythematosus (SLE), has been suggested . In a large case‐control study, the prevalence of any autoimmune condition was higher in subjects with FGIDs compared to controls without them, and the association persisted after controlling by age and gender, implying that the increased prevalence cannot be due to known associations of FGIDs . In a recent large Australian population‐based study, food allergies, psoriasis, and rheumatoid arthritis were independent risk factors for IBS after controlling for age, gender, and psychological distress.…”

Section: Introductionmentioning

confidence: 99%

“…6 Despite this negative impact, the lack of a defined etiology limits therapies. 7 Recent advances in our understanding of the involvement of abnormalities in intestinal immunology in FGIDs/DGBI, such as immune activation and low-grade inflammation, 8,9 suggest that an indirect inflammatory phenotype underlies the physiopathology mechanism in a subset of these patients. Therefore, a link between FGIDs/DGBI such as functional dyspepsia, irritable bowel syndrome (IBS), functional constipation, and autoimmune disorders, including systemic lupus erythematosus (SLE), has been suggested.…”

Section: Introductionmentioning

confidence: 99%

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Functional gastrointestinal disorders in women with systemic lupus erythematosus: A case‐control study

Garcı́a-Carrasco

Mendoza‐Pinto

Munguía‐Realpozo

et al. 2019

Neurogastroenterology Motil

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Background Systemic lupus erythematosus (SLE) is an autoimmune disease with multisystemic involvement. Gastrointestinal (GI) manifestations are frequent but functional gastrointestinal disorders (FGIDs) have scarcely been studied in SLE. To determine the prevalence of FGIDs and their potential risk factors in SLE female patients vs controls. Methods Systemic lupus erythematosus patients meeting the American College of Rheumatology (ACR) criteria and controls completed the Rome III questionnaire for FGIDs and a structured interview to assess sociodemographic, clinical, and treatment variables after excluding organic GI diseases. Logistic regression was used to determine risk factors (ie, alcohol drinking, medications) for FGIDs. Key Results Responders included 113 SLE patients and 122 age‐matched controls. The presence of at least one FGIDs was higher in SLE (73.4%) vs controls (54.1%), P = .003. The most frequent FGIDs in SLE patients were nausea and vomiting disorders (NVD), belching disorders, globus, anorectal pain, functional heartburn (FH), and functional bloating (FB). After adjustment for confounding variables, SLE was associated with NVD (OR: 7.1, 95% CI: 2.7‐19.1) globus (3.5, 1.3‐9.3), anorectal pain (3.4, 1.4‐8.4), and FH (2.5, 1.5‐4.4). The simultaneous presence of >1 FGID was more common in SLE patients than controls (69.8% vs 31.8%). Glucocorticoids (5.2, 1.3‐19.9) and non‐steroidal anti‐inflammatory drugs (NSAIDs; 3.0, 1.1‐8.0) were associated with any FGID in SLE patients while alcohol drinking with gallbladder/sphincter of Oddi disorders 7.4 (1.1‐47.3). Conclusions and Inferences Functional gastrointestinal disorders are more frequent in SLE patients compared with controls. Medication that may alter gastrointestinal homeostasis, such as glucocorticoids and NSAIDs, are potential risk factors for FGIDs in SLE.

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The enteric nervous system in gastrointestinal disease etiology

Holland

Bon-Frauches

Keszthelyi

et al. 2021

Cell. Mol. Life Sci.

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A highly conserved but convoluted network of neurons and glial cells, the enteric nervous system (ENS), is positioned along the wall of the gut to coordinate digestive processes and gastrointestinal homeostasis. Because ENS components are in charge of the autonomous regulation of gut function, it is inevitable that their dysfunction is central to the pathophysiology and symptom generation of gastrointestinal disease. While for neurodevelopmental disorders such as Hirschsprung, ENS pathogenesis appears to be clear-cut, the role for impaired ENS activity in the etiology of other gastrointestinal disorders is less established and is often deemed secondary to other insults like intestinal inflammation. However, mounting experimental evidence in recent years indicates that gastrointestinal homeostasis hinges on multifaceted connections between the ENS, and other cellular networks such as the intestinal epithelium, the immune system, and the intestinal microbiome. Derangement of these interactions could underlie gastrointestinal disease onset and elicit variable degrees of abnormal gut function, pinpointing, perhaps unexpectedly, the ENS as a diligent participant in idiopathic but also in inflammatory and cancerous diseases of the gut. In this review, we discuss the latest evidence on the role of the ENS in the pathogenesis of enteric neuropathies, disorders of gut–brain interaction, inflammatory bowel diseases, and colorectal cancer.

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Functional Gastrointestinal Disorders: Complex Treatments for Complex Pathophysiological Mechanisms

Cited by 24 publications

References 16 publications

Burden of functional gastrointestinal disorders in a surgical clinic in Sri Lanka

Burden of functional gastrointestinal disorders in a surgical clinic in Sri Lanka

Functional gastrointestinal disorders in women with systemic lupus erythematosus: A case‐control study

The enteric nervous system in gastrointestinal disease etiology

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