Gut Inflammation: More Than a Peripheral Annoyance

Excerpt

More than 15% of the adult population of the Western world suffers from functional gastrointestinal disorders (FGID); in tertiary hospitals in Australia ~20% of referrals are due to FGID. Disease mechanisms involved in FGID include alterations of visceral sensory and gastrointestinal motor function, minimal mucosal inflammation, alterations of the gut microbiome, and altered central processing of visceral afferent neural inputs. In recent years, the Rome Committee has developed and refined symptom-based diagnostic criteria such as functional dyspepsia (FD) and irritable bowel syndrome (IBS) [1]. FD is defined by symptoms referred to the epigastric region and upper gastrointestinal tract with the two principal categories: postprandial distress syndrome (PDS) defined by postprandial fullness and/or early satiation and epigastric pain syndrome (EPS) with epigastric pain or burning. IBS in contrast is defined by symptoms referred to the abdominal cavity such as pain or bloating associated with an alteration of bowel movements. However, FD and IBS occur in the absence of conventionally diagnosed organic disease. In the clinical setting, the majority of patients with severe or very severe symptoms report overlapping FD and IBS symptoms. In both conditions, gastrointestinal hypersensitivity to routine inputs is a central hallmark believed to substantially contribute to symptom manifestations [2]. Subsequently, animal models have been developed to support detailed investigation of altered gastrointestinal viscerosensory function. …