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Organic and functional disorders in 2000 gastroenterology outpatients.

To determine the relative frequency of different diseases and of functional gastrointestinal disorders among patients referred by general practitioners to a gastroenterology clinic, 2000 patients referred over a five-year period were studied. 980 had organic diseases, of which peptic ulcer, oesophagitis, and inflammatory bowel disease accounted for about half. 888 patients had functional disorders of the gastrointestinal tract, without any disease. Among these, various syndromes could be distinguished; abdominal pain with altered bowel habit (irritable bowel syndrome, spastic colon type) accounted for about half of these patients. More attention could profitably be directed towards understanding these common functional syndromes so that they can be more readily diagnosed and better managed.

Colonic Diseases, Functional↗

[Irritable colon. Possibilities for an objective diagnosis and its value for the therapy].

Diagnosis of functional gastrointestinal disorders consists mainly in exclusion of organic diseases. A more positive diagnosis may be established by the identification of characteristic symptoms. Myography and manometry within the colon sigmoideum reveal significant patterns in irritable bowel patients, which also may allow control of therapy.

Colonic Diseases, Functional↗

Chronic diffuse musculoskeletal pain, fibromyalgia and co-morbid unexplained clinical conditions.

This chapter reviews our current knowledge on the presence of overlapping syndromes in one form of chronic diffuse pain, fibromyalgia. Patients with fibromyalgia often present with signs and symptoms of other unexplained clinical conditions, including chronic fatigue syndrome, irritable bowel syndrome, temporomandibular disorders, and multiple chemical sensitivities. The high prevalence, impact on function and opportunities for treatment underscore the need for clinicians and researchers to screen routinely for co-morbid unexplained clinical conditions among persons with fibromyalgia. We, therefore, describe a simple approach to screening for such conditions in accordance with published criteria. Interventions should directly address both fibromyalgia symptoms and co-morbid unexplained clinical conditions, as well as the multiple factors that propagate pain, fatigue and limitations in function.

Chronic Disease↗