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Functional and GI motility disorders
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This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.
While functional gastrointestinal diseases are very common in the general population, these however, remain poorly understood by both clinicians and basic scientists. Therefore, these diseases pose considerable challenges to clinicians in their management in day-to-day practice. There has been a considerable advancement in the understanding of pathophysiology of functional and motility disorders of gastrointestinal tract over the past decade which has led to a flurry of publications in this field. While one would want to keep oneself abreast with the progresses made in the field, it however, may not be possible for most clinicians to keep themselves updated.
This book is a good resource for clinicians providing updated and clinically relevant information on functional and GI motility disorders. The authors of each chapter are well-known clinical scientists with experience in dealing with functional GI and motility disorders.
In the first chapter, the authors have used illustrative images to discuss the pathophysiology, clinical approach and management of oropharyngeal dysphagia and other swallowing disorders which may be useful to the readers. With the advent of high resolution manometry and impedance manometry, our understanding of oesophageal peristalsis and bolus transit through the oesophagus has advanced markedly. Some of these abnormalities such as weak peristalsis, peristaltic break are discussed in the chapter, “Nonobstructive Dysphagia”. Chronic intestinal pseudo-obstruction, while being an uncommon disease, poses challenges in making aetiological diagnosis, which is discussed in chapter 5. This chapter is the informative and allows understanding of the neuropathological basis of this disorder. In chapter 7, the authors guide the reader on how and when to do colonic motility studies, while chapter 8 addresses the challenges and approach to a patient with difficult to treat constipation.
Since the pathophysiology of many GI motility and functional disorders is still not well understood, there is a lag in the development of target specific drugs. Despite these limitations, there have been a number of targets which are being explored and some of these are likely to appear in clinical use in the near future. The progress in the pharmacology of gut-brain axis has been summed up in chapter 11.
Another unique feature of this book is the inclusion of four chapters, each dedicated to GI motility issues in patients admitted to the intensive care unit, neurodevelopmental diseases in childhood, neurological and neurodegenerative diseases in adults and postoperative periods, respectively. While GI motility dysfunctions are common in these patients it poses challenges to the treating clinician in managing patients with neurodevelopmental diseases, and neurodegenerative diseases. The chapters included in this book are a useful guide to manage such patients.
While this book covers a wide array of contemporary topics related to functional and GI motility disorders, there is no chapter on achalasia. In summary, this book is a valuable reading material for clinicians who deal with functional and GI motility gastrointestinal disorders.
