Common Functional Gastroenterological Disorders Associated With Abdominal Pain

Adil Eddie Bharucha, Subhankar Chakraborty, Christopher D. Sletten

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

Although abdominal pain is a symptom of several structural gastrointestinal disorders (eg, peptic ulcer disease), this comprehensive review will focus on the 4 most common nonstructural, or functional, disorders associated with abdominal pain: functional dyspepsia, constipation-predominant and diarrhea-predominant irritable bowel syndrome, and functional abdominal pain syndrome. Together, these conditions affect approximately 1 in 4 people in the United States. They are associated with comorbid conditions (eg, fibromyalgia and depression), impaired quality of life, and increased health care utilization. Symptoms are explained by disordered gastrointestinal motility and sensation, which are implicated in various peripheral (eg, postinfectious inflammation and luminal irritants) and/or central (eg, stress and anxiety) factors. These disorders are defined and can generally be diagnosed by symptoms alone. Often prompted by alarm features, selected testing is useful to exclude structural disease. Identifying the specific diagnosis (eg, differentiating between functional abdominal pain and irritable bowel syndrome) and establishing an effective patient-physician relationship are the cornerstones of therapy. Many patients with mild symptoms can be effectively managed with limited tests, sensible dietary modifications, and over-the-counter medications tailored to symptoms. If these measures are not sufficient, pharmacotherapy should be considered for bowel symptoms (constipation or diarrhea) and/or abdominal pain; opioids should not be used. Behavioral and psychological approaches (eg, cognitive behavioral therapy) can be helpful, particularly in patients with chronic abdominal pain who require a multidisciplinary pain management program without opioids.

Original languageEnglish (US)
Pages (from-to)1118-1132
Number of pages15
JournalMayo Clinic Proceedings
Volume91
Issue number8
DOIs
StatePublished - Aug 1 2016

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Abdominal Pain
Irritable Bowel Syndrome
Constipation
Opioid Analgesics
Diarrhea
Patient Acceptance of Health Care
Diet Therapy
Physician-Patient Relations
Gastrointestinal Motility
Fibromyalgia
Irritants
Dyspepsia
Cognitive Therapy
Pain Management
Peptic Ulcer
Chronic Pain
Anxiety
Quality of Life
Depression
Psychology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Common Functional Gastroenterological Disorders Associated With Abdominal Pain. / Bharucha, Adil Eddie; Chakraborty, Subhankar; Sletten, Christopher D.

In: Mayo Clinic Proceedings, Vol. 91, No. 8, 01.08.2016, p. 1118-1132.

Research output: Contribution to journalReview article

Bharucha, Adil Eddie ; Chakraborty, Subhankar ; Sletten, Christopher D. / Common Functional Gastroenterological Disorders Associated With Abdominal Pain. In: Mayo Clinic Proceedings. 2016 ; Vol. 91, No. 8. pp. 1118-1132.
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