Author: Spiller RC.

Institution: Division of Gastroenterology, The Wolfson Digestive Disease Centre, University Hospital, Nottingham NG7 2UH, UK. robin.spiller@nottingham.ac.uk

Summary: The term 'Functional diseases' implies symptoms arising from an organ without overt pathology. However this is more apparent than real since inflammation often leaves changes in nerves and mucosal function only apparent with specialised techniques.

Acute onset functional dyspepsia accounts for around 1/5 of functional dyspepsia and is characterised by early satiety, nausea, vomiting and weight loss. Impaired postcibal fundal accommodation may underlie some of these symptoms. Post infectious gastroparesis is much rarer and is associated with markedly delayed gastric emptying and antral hypomotility. Approximately 1/10 of IBS cases describe a post infectious onset.

Post infectious IBS is typically of the diarrhoea-predominant type. Post inflammatory functional diseases tend to be associated with less psychological abnormalities and have a better prognosis than other functional diseases. There are isolated anecdotal reports of symptom response to anti-inflammatory treatments but larger controlled trials are needed.

Study link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15324705&query_hl=94

• Mast Cell Involvement in Gastritis With or Without Helicobacter Pylori Infection
• Gastric Mucosal Mast Cells are Increased in Helicobacter pylori-negative Functional Dyspepsia
• Inflammation as a Basis for Functional GI Disorders
• Gastric Inflammatory Markers and Interleukins in Patients with Functional Dyspepsia, With and Without Helicobacter Pylori Infection