Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts
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 betwe...
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| Format: | Article |
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BMJ Publishing Group
2017
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| Online Access: | https://eprints.nottingham.ac.uk/44213/ |
| _version_ | 1848796863437733888 |
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| author | Tack, Jan Corsetti, Maura Camilleri, Michael Quigley, Aaron Simren, Magnus Suzuki, Hidekazu Talley, Nicholas J. Tornbloom, Hans Van Oudenhove, Lukas |
| author_facet | Tack, Jan Corsetti, Maura Camilleri, Michael Quigley, Aaron Simren, Magnus Suzuki, Hidekazu Talley, Nicholas J. Tornbloom, Hans Van Oudenhove, Lukas |
| author_sort | Tack, Jan |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T19:54:44Z |
| format | Article |
| id | nottingham-44213 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:54:44Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
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| spelling | nottingham-442132020-05-04T19:00:48Z https://eprints.nottingham.ac.uk/44213/ 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 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. BMJ Publishing Group 2017-08-16 Article PeerReviewed Tack, Jan, Corsetti, Maura, Camilleri, Michael, Quigley, Aaron, Simren, Magnus, Suzuki, Hidekazu, Talley, Nicholas J., Tornbloom, Hans and Van Oudenhove, Lukas (2017) Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts. Gut . ISSN 1468-3288 Functional gastrointestinal disorders Pathophysiological mechanisms Gastrointestinal motility Gastroesophageal reflux Visceral hypersensitivity Plausibility criteria http://gut.bmj.com/content/early/2017/08/16/gutjnl-2016-312230 doi:10.1136/gutjnl-2016-312230 doi:10.1136/gutjnl-2016-312230 |
| spellingShingle | Functional gastrointestinal disorders Pathophysiological mechanisms Gastrointestinal motility Gastroesophageal reflux Visceral hypersensitivity Plausibility criteria Tack, Jan Corsetti, Maura Camilleri, Michael Quigley, Aaron Simren, Magnus Suzuki, Hidekazu Talley, Nicholas J. Tornbloom, Hans Van Oudenhove, Lukas Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| title | Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| title_full | Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| title_fullStr | Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| title_full_unstemmed | Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| title_short | Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| title_sort | plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts |
| topic | Functional gastrointestinal disorders Pathophysiological mechanisms Gastrointestinal motility Gastroesophageal reflux Visceral hypersensitivity Plausibility criteria |
| url | https://eprints.nottingham.ac.uk/44213/ https://eprints.nottingham.ac.uk/44213/ https://eprints.nottingham.ac.uk/44213/ |