| Theme |
The Functional Gastrointestinal Disorders -- Clinical Practice Based on the Understanding of Its Basic Mechanisms |
| Title |
Upper Abdominal Symptoms Related to Gastric Acid Reflux and Impaired Enterokinesis |
| Author |
Shotaro Enomoto |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Masashi Oka |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Mikitaka Iguchi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Kimihiko Yanaoka |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Hideyuki Tamai |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Masao Ichinose |
Second Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
Functional gastrointestinal disorders, which cause various upper abdominal symptoms such as heartburn, epigastric pain, and gastric discomfort in the absence of organic disorders, include functional dyspepsia (FD), non-erosive reflux disease (NERD), and functional heartburn. In the Rome III and Montreal Definition criteria, which are internationally employed, these disorders are defined based on symptoms. Multiple factors, including gastroesophageal reflux, impaired enterokinesis, hyperesthesia of the digestive tract, and mental/psychological factors, may be involved in the pathogenesis of functional gastrointestinal disorders. These disorders are difficult to differentiate, and overlap in many cases. For their diagnosis, it is clinically useful to evaluate various symptoms using specific questionnaire such as frequency scales to determine the symptoms of gastroesophageal reflux disease (FSSG). When the presence of organic disorders is ruled out, functional tests should be individually selected, considering the possibility of NERD or functional heartburn in patients with heartburn, as well as the possibility of postprandial distress syndrome (PDS) or epigastric pain syndrome (EPS) in those with dyspepsia. |