ABSTRACT
This chapter reviews the evidence to support therapies in non-ulcer dyspepsia and irritable bowel syndrome (IBS), and introduces the reader to the novel therapeutic approaches that are on the threshold to clinical application. Abnormal visceral perception has been demonstrated in patients with IBS by rectosigmoid, ileal and anorectal balloon distention. Diarrhea-predominant IBS patients exhibit lower thresholds for sensation of gas, stool, discomfort and urgency when elicited by progressive rectal balloon distention, this is also accompanied by the development of excessive reflex contractile activity in the rectum. Psychologic symptoms such as somatization, anxiety, hostility, phobia and paranoia are more common in patients with IBS. Non-ulcer dyspepsia is a symptom complex characterized by postprandial upper abdominal discomfort or pain, early satiety, nausea, vomiting, abdominal distension, bloating, and anorexia in the absence of organic disease. In general, antisecretory agents provide little benefit in the treatment of non-ulcer dyspepsia.
