Dysmotility & Nutrition

Functional GI disease (<30 types per Rome IV criteria; Gastro 2016;150:1257)

  • Recurrent GI sx caused by disorders of gut-brain interaction rather than structural cause
  • Irritable bowel syndrome (IBS) (JAMA 2015;313:949; Gastro 2015;149:1399 & 2018;154:1140)
    • Abd discomfort a/w ≥2 of following: improve w/ defecation, Δ stool frequency, Δ stool form
    • IBS-C (constipation predominant) vs. IBS-D (diarrhea predominant) vs. IBS-M (mixed) vs. IBS-U (unclassified). Sx may be affected by stress, diet, lifestyle, probably microbiome.
    • Treatment: cog. behavioral Rx, probiotics, exercise, consider gut-brain modulators (eg, TCA, SSRI), Δ diet (↓ fermentable short-chain carbohydrates)