Abstract
Symptoms related to abnormal gastrointestinal motility and function are common. Oropharyngeal and oesophageal dysphagia, heartburn, bloating, abdominal pain and alterations in bowel habits are among the most frequent reasons for seeking medical attention from internists or general practitioners and are also common reasons for referral to gastroenterologists and colorectal surgeons. However, the nonspecific nature of gastrointestinal symptoms, the absence of a definitive diagnosis on routine investigations (such as endoscopy, radiology or blood tests) and the lack of specific treatments make disease management challenging. Advances in technology have driven progress in the understanding of many of these conditions. This Review serves as an introduction to a series of Consensus Statements on the clinical measurements of gastrointestinal motility, function and sensitivity. A structured, evidence-based approach to the initial assessment and empirical treatment of patients presenting with gastrointestinal symptoms is discussed, followed by an outline of the contribution of modern physiological measurement on the management of patients in whom the cause of symptoms has not been identified with other tests. Discussions include the indications for and utility of high-resolution manometry, ambulatory pH-impedance monitoring, gastric emptying studies, breath tests and investigations of anorectal structure and function in day-to-day practice and clinical management.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 568-579 |
| Number of pages | 12 |
| Journal | Nature Reviews Gastroenterology and Hepatology |
| Volume | 15 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 1 2018 |
Funding
M.R.F. has received funding of research and/or support of educational projects from Astra Zeneca, Given Imaging/ Medtronic, Mui Scientific, Nestlé, Reckitt Benckiser, and Sandhill Scientific Instruments and Medical Measurement Systems. S.R. has served as a consultant for Medtronic. She received research support from Crospon and Sandhill Scientific. C.P.G. has served as a consultant and speaker for Medtronic and has also received research funding from Medtronic. He has served as a consultant for Ironwood, Quintiles and Torax and as a speaker for Allergan. S.M.S. has received honoraria from Medical Measurement Systems/ Laborie for providing training webinars and organizing teaching courses. He has also received research funding from Mui Scientific and Nestec. S.S.R. has served on advisory boards for Forest Laboratories, Intone, Synergy and Vibrant and has received research grants from Forest Laboratories, Intone, Medtronic and Synergy. J.K. has received funds for research from Given Imaging/Medtronic and Standard Instruments. She has acted as a paid consultant and/or has been paid for speaking by Abbott, Allergan, AstraZeneca, Falk Foundation, Mundipharma, Nordmark, Shire and Sucampo. M.C. has received honoraria from Biokier and Kallyope, research support from Astra Zeneca, NGM Pharma and Rhythm Pharmaceuticals, and medication supplies for clinical trials from NovoNordisk. P.J.K. declares no competing interests.
ASJC Scopus subject areas
- Hepatology
- Gastroenterology