Irritable bowel syndrome and dysphagia

Functional gastrointestinal disorders constitute a set of gastrointestinal disorders with absence of obvious organic and physiological dysfunctions observed in clinical routine examinations. The functional disorders are divided into many subclasses, e.g., functional esophageal disorders and functional bowel disorders. The diagnoses are set when the patients fulfil the Rome IV criteria after a careful anamnestic history and exclusion of organic diseases in appropriate investigations. The disorders have a high prevalence in the population worldwide, but are of a benign nature. The etiology and pathophysiology are unknown, but environmental factors, genetics, and psychosocial factors seem to be of importance. Visceral hypersensitivity and hyperalgesia are found. There is a great comorbidity between different functional gastrointestinal disorders, and between these disorders and other chronic pain syndromes characterized by central hypersensitivity, which are all included in the term somatic symptom disorder. The most common of the functional bowel disorders is irritable bowel syndrome (IBS), characterized by abdominal pain in association with altered bowel habits. Functional esophageal disorders represent functional chest pain, functional heartburn, reflux hypersensitivity, globus, and functional dysphagia. The most important in the treatment of these conditions are confirmation and reassurance of the symptoms and their benign nature. Dietary advices and symptomatic drug treatment against specific symptoms are the first line of prescription. If these interventions do not improve symptoms, prescription of antidepressants and psychological and behavioral therapy are recommended