Lin ChangMD and Douglas A DrossmanMD

Functional gastrointestinal disorders (FGIDs) are defined as a "variable combination of chronic or recurrent gastrointestinal (GI) symptoms not explained by structural or biochemical abnormalities." A number of specific disorders ranging from functional heartburn to functional dyspepsia to irritable bowel syndrome (IBS) are considered as FGIDs. The principal underlying mechanism is felt to be a dysregulated brain gut axis resulting in the alteration of gut motility, mechanoelastic properties and visceral perception. Many factors (both central and peripheral) may contribute to this dysregulation, including genetic predisposition, psychosocial factors and chronic stress, inflammation/infection, and other environmental factors.

The FGIDs are best understood as a biopsychosocial disorder. Early life factors (eg, genetic predisposition and environmental factors) influence later psychological experiences, physiologic functioning, and the subsequent vulnerability and development of symptoms of FGIDs. The biopsy-chosocial model integrates psychologic and physiologic factors into the conceptual framework that helps explain the clinical symptoms, illness behavior, and treatment outcome. Thus, it is not surprising that centrally targeted medications (psychotropics) are frequently used to treat FGIDs because of both central and visceral effects. This chapter will include the discussion of the rationale, the evidence supporting the use of psychotropic medications, and the practical use of these agents in the treatment of FGIDs. The preceeding chapter also discusses IBS management. A recent drug therapy in IBS is reviewed by Mertz (Mertz, 2003).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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