ABSTRACT
Functional gastrointestinal disorders constitute almost 50% of patients seen in outpatient gastroenterology clinics in the Western world. These disorders are characterized by single or multiple symptoms that are unassociated with any demonstrable etiology; that is, anatomical, mucosal, and biochemical alterations are undetected. This chapter focuses on the clinical approach and the use of structural and functional investigations in the evaluation of patients presenting with such symptoms. A careful history is essential and provides clues to the nature of the patient’s complaints. As shown in Table 1, the predominant symptoms indicate to the clinician the likely region affected. Even when the symptoms are highly suggestive of a functional gastrointestinal disorder, most patients require empathetic explanation, a reasonable degree of psychosocial sensitivity (at least a caring attitude and education by the generalist or gastroenterologist), and some degree of further testing to exclude organic disease.
