Skip to main content

Research Repository

Advanced Search

Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts

Tack, Jan; Corsetti, Maura; Camilleri, Michael; Quigley, Aaron; Simren, Magnus; Suzuki, Hidekazu; Talley, Nicholas J.; Tornbloom, Hans; Van Oudenhove, Lukas

Authors

Jan Tack

Michael Camilleri

Aaron Quigley aquigley@acm.org

Magnus Simren

Hidekazu Suzuki

Nicholas J. Talley

Hans Tornbloom

Lukas Van Oudenhove



Abstract

The functional gastrointestinal disorders (FGIDs), are extremely common conditions associated with a considerable personal, social and health economic burden. Managing FGIDs in clinical practice is challenging because of the uncertainty of symptom-based diagnosis, the high frequency of overlap between these conditions and the limited efficacy of available therapies. It has often been argued that successful drug development and management of FGIDs requires knowledge of the underlying pathophysiology. Numerous and highly variable candidate pathophysiological mechanisms have been implicated in the generation of FGID symptoms, but there is no current consensus on how to best define the relevance of these disturbances. Methods: A group of international experts on FGIDs developed plausibility criteria that should be fulfilled by relevant pathophysiological mechanisms in FGIDs. Results: Five criteria are proposed: 1) presence of the abnormality in a subset of patients; 2) temporal association between proposed mechanism and symptom(s); 3) correlation between the level of impairment of the mechanism and symptom(s); 4) induction of the symptom(s) by provoking the pathophysiological abnormality in healthy subjects and 5) treatment response by a therapy specifically correcting the underlying disorder, or congruent natural history of symptoms and dysfunction in the absence of specific therapy. Based on strength of evidence for these 5 criteria, a plausibility score is proposed. Conclusion: Evaluation of the strength of evidence for candidate pathophysiological abnormalities fulfilling these 5 plausibility criteria will help to identify the most relevant mechanisms to target for novel diagnostic approaches and for the development of new therapies.

Journal Article Type Article
Journal Gut
Print ISSN 0017-5749
Electronic ISSN 1468-3288
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
APA6 Citation Tack, J., Corsetti, M., Camilleri, M., Quigley, A., Simren, M., Suzuki, H., …Van Oudenhove, L. (in press). Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts. Gut, https://doi.org/10.1136/gutjnl-2016-312230
DOI https://doi.org/10.1136/gutjnl-2016-312230
Keywords Functional gastrointestinal disorders, Pathophysiological mechanisms, Gastrointestinal motility, Gastroesophageal reflux, Visceral hypersensitivity, Plausibility criteria
Publisher URL http://gut.bmj.com/content/early/2017/08/16/gutjnl-2016-312230
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information ©2017 BMJ Publishing Group Ltd & British Society of Gastroenterology

Files

PlausibilityPaper_2017.pdf (443 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





You might also like



Downloadable Citations

;