The functional gastrointestinal disorders and the Rome II process

Author(s): Drossman DA

Abstract

Throughout recorded history, and alongside structural diseases of the intestinal tract, are maladies that have produced multiple symptoms of pain, nausea, vomiting, bloating, diarrhea, constipation, or difficult passage of food or feces.

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 Although structural diseases can be identified by pathologists and at times cured by medical technology, the nonstructural symptoms that we describe as “functional” remain enigmatic and less amenable to explanation or effective treatment. Often considered “problems of living,” there are physiological, intrapsychic, and sociocultural factors that amplify perception of these symptoms so they are experienced as severe, troublesome, or threatening, with subsequent impact on daily life activities. Those suffering from such symptoms attribute them to an illness and self-treat or seek medical care. Traditionally trained physicians then search for a disease (inflammatory, infectious, neoplastic and other structural abnormalities) in order to make a diagnosis and offer treatment specific to the diagnosis. In most cases,

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 no structural etiology is found, the doctor concludes that the patient has a “functional” problem, and the patient is evaluated and treated accordingly.

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