Today's therapy of functional gastrointestinal disorders - Does it help?

Functional gastrointestinal disorders are best understood by applying a bio -psycho-social model. The diseases are strongly associated with psychologic al factors, and in functional dyspepsia, low vagal activity might be a medi ating mechanism by which psychological factors (Like neuroticism and stress ) influence gastrointestinal physiology and cause epigastric discomfort. Lo w vagal activity may be a manifestion of stress and a cause of impaired gas tric accommodation to meals. Epigastric discomfort is elicited when the sto mach is distended without prior (vagal) reflex relaxation. Conventional the rapy for acid-related dyspepsia does not improve accommodation and hence, i s ineffective. The beneficial effect of experimental therapy, Like glyceryl trinitrate and sumatriptan, which improve gastric accommodation, gives ver y good prospects for further development. For patients with irritable bowel syndrome, today's therapy seems similarly inefficacious, but several new p otentially effective drugs are at present undergoing clinical trials.