Symptoms Of Functional Disorders Research Articles

Features of the motor function of the gastrointestinal tract at the cross-functional pathology

Aim. To identify the role of impaired motor function of the gastrointestinal tract (GIT) in the overlap of functional disorders (FD).
 Materials and methods. Thirty-two abdominal FD patients were followed up, with a predominance of women aged 33.76.1 years (75%). Men aged 31.85.6 years were 25%. All patients had symptoms of GIT FD established according to the Rome IV criteria, endoscopy, and abdominal ultrasound. In addition, patients underwent 2-hour pH-metry and electromyography of the abdominal organs using bipolar silver electrodes with a surface area of 0.50.6 cm2. The amplitude-frequency characteristics of slow waves and spikes and the power of phase and tonic contractions were analyzed using the Canon M hardware and software complex with a transmission frequency of 0.1 to 10 Hz and a noise level of 15 W.
 Results. Overlapping clinical symptoms of motor disorders in gastrointestinal tract functional disorders are observed at a young age, mainly in women. The abnormal ratio of the gallbladder and common bile duct motility in overlapping GIT FD was 1:1.08, with a pronounced increase in contractions of the common bile duct, which could lead to an increase in pressure in the biliary system, pain, and insufficient flow of bile to the duodenum, disrupting the digestion and worsening the dyspepsia.
 Conclusion. The study showed a tendency for higher incidence of functional disorders in young women. Patients with overlapping disorders also have more severe pain than those with isolated disorders.

Evaluation of bladder and bowel functions in children with microcephaly and congenital zika syndrome

Children with Congenital Zika Syndrome (CZS) present structural cortical changes that may compromise the integrity of their connections with urinary and digestive systems, causing bowel and bladder dysfunctions. To evaluate bladder and bowel dysfunction (BBD) in children with CZS. This is an observational cross-sectional study of a series of CZS cases. Urinary tracts were investigated using a bladder function protocol consisting of clinical history, detailed physical examination, laboratory tests, ultrasound of the lower and upper urinary tracts, and urodynamic evaluation. The bowel function protocol expanded anamnesis with questions related to signs and symptoms of functional disorders, Bristol scale, and ultrasound of the rectal ampoule. Forty children with CZS, aged between one and five years were included. The majority (80%) had bladder and bowel dysfunction (BBD), 12.5% had bladder dysfunction only, and 7.5% only bowel dysfunction. A reduced bladder capacity was confirmed in 36 patients (90%), while 15 (40%) presented postvoid residual greater than 20% of their cystometric capacity. Thirty-five patients (87.5%) presented four signs/symptoms of functional bowel disorders and the rectal ampoule ultrasound was >2.9cm in 21 (52.5%). Moreover, 19 (47.5%) presented urinary tract infection, while 5 (12.5%) developed pyelonephritis and required hospitalization. Renal ultrasound showed nephrolithiasis in three (7.5%), one (2.5%) presented horseshoe kidney, and a duplicated collecting system was found in three patients. Cryptorchidism was presented in eight (34%). Our study confirmed the presence of BBD in 80% of the children with CZS studied in this series. This is the first time that bowel dysfunction is confirmed in the settings of CZS. This recognition will facilitate early identification and appropriate therapies in an attempt to reduce complications. One limitation of the study is the absence of a control group. Due to the new aspects of CZS, it has been difficult to find a suitable group of patients with neurological disorders to compare and performing urodynamic studies in children without neurological or non-neurological voiding dysfunction is unethical. Appropriate control groups for future studies may be children with microcephaly due to other causes or older children with CZS who were not yet investigated or treated. Another limitation is the lack of a standard quantitative evaluation of bowel dysfunction in children with neurological disorders. Bladder and bowel dysfunction was confirmed in 80% of the children with CZS. This is a new Zika virus-associated neuromuscular disorder that needs to be further investigated.

Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract - EFSUMB Consensus Statement.

Abdominal ultrasonography and intestinal ultrasonography are widely used as first diagnostic tools for investigating patients with abdominal symptoms, mainly for excluding organic diseases. However, gastrointestinal ultrasound (GIUS), as a real-time diagnostic imaging method, can also provide information on motility, flow, perfusion, peristalsis, and organ filling and emptying, with high temporal and spatial resolution. Thanks to its noninvasiveness and high repeatability, GIUS can investigate functional gastrointestinal processes and functional gastrointestinal diseases (FGID) by studying their behavior over time and their response to therapy and providing insight into their pathophysiologic mechanisms. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has established a Task Force Group consisting of GIUS experts, which developed clinical recommendations and guidelines on the role of GIUS in several acute and chronic gastrointestinal diseases. This review is dedicated to the role of GIUS in assisting the diagnosis of FGID and particularly in investigating patients with symptoms of functional disorders, such as dysphagia, reflux disorders, dyspepsia, abdominal pain, bloating, and altered bowel habits. The available scientific evidence of GIUS in detecting, assessing, and investigating FGID are reported here, while highlighting sonographic findings and its usefulness in a clinical setting, defining the actual and potential role of GIUS in the management of patients, and providing information regarding future applications and research.

Балалар үйінде тәрбиеленуші балалар мен жасөспірімдердің шықшыт буыны дисфункциясы симптомдарының кездесу жиілігі

Diseases of the temporomandibular joint (TMJ) occur in 20-76% of the population, of which up to 70-89% are functional joint disorders. In children and adolescents, TMJ dysfunction occurs in 14-20%. Among the variety of pathogenetic factors in the development of this pathology, the most important are: stress, psychological disorders, imbalance in the tone of the masticatory muscles, occlusive disharmony. Purpose of the study. To study the prevalence of symptoms of TMJ dysfunction, including prenosological, in children and adolescents living in orphanages. Material and research methods. The frequency of occurrence of symptoms of functional disorders of the TMJ, including prenosological, was studied in 331 children and adolescents living in orphanages. The comparison group consisted of 218 students of secondary school No. 30 in the city of Almaty. Results and discussion. These symptoms were found in 32.62% of children and adolescents living in orphanages in the city of Almaty, and in 35.32% of practically healthy individuals, and their frequency increased with age. More common in girls. In different combinations there were revealed the dislocation of the middle inter-incisive line, pain on palpation of the masseter muscles, joint noise, malopening mouth. Dentofacial anomalies were more often observed in children and adolescents with certain symptoms of functional disorders of the temporomandibular joint. Keywords: temporomandibular joint malfunction, children and adolescents living in orphanages.

A Patient with Symptoms Caused by Electric Shock Treated with Traditional Korean Medicine

This case report describes a 60-year-old female patient diagnosed with intercostal neuropathy and vertebral compression fractures which occurred following an electric shock injury. The patient received acupuncture, pharmacopuncture, and herbal medicine administration between February 10th, 2020 and April 25th, 2020. The pain level in the thoracic and left intercostal areas was assessed using the Numerical Rating Scale. The Self-report of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were used to diagnose neuropathic pain. The Neuropathic-Pain -Scale was used to evaluate the degree of neuropathic symptoms. The Oswestry Disability Index and the European Quality of Life-5 Dimensions were used to assess quality of life scales and functional disorder. Following combined Korean medicine treatment, the patient exhibited reduced levels of pain and significant improvement in functional disorder symptoms and quality of life.

A Patient with Ankylosing Spondylitis Treated with Acupotomy and Traditional Korean Medicine

This case report relates to a 40-year old male patient diagnosed with ankylosing spondylitis who was treated with acupotomy and traditional Korean medicine. He showed a significant improvement in joint range of motion (ROM) in cervical and lumbar vertebrae, and in pain and functional disorder symptoms. The patient received acupotomy, acupuncture, pharmacopuncture, herbal medicine and physical therapy (November 26, 2018 to December 17, 2018). Joint ROM for cervical and lumbar vertebrae was measured, and the pain level was assessed using a numerical rating scale. The functional disorder and quality of life scales were also assessed using the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Korean Health Assessment Questionnaire, and Modified Health Assessment Questionnaire. After applying acupotomy and traditional Korean medicine, the patient exhibited increased joint ROM and reduced pain, also in conjunction with improved responses in functional disorder and quality of life. ©2019 Korean Acupuncture & Moxibustion Medicine Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Selected ENT symptoms in functional disorders of the upper cervical spine and temporomandibular joints.

This paper discusses otorhinolaryngological symptoms associated with functional disorders of the upper cervical spine. Hints aimed to avoid misdiagnoses of cross-organ otorhinolaryngological symptoms as phobic or psychogenic disorders are presented. Clinically relevant neuroanatomical convergence of the upper cervical spine (occiput to C3) is fundamental for the interpretation of functional otorhinolaryngological symptoms. Based thereon, evidence for the most common cervical differential diagnoses of dizziness, tinnitus, dysphagia, and craniomandibular dysfunction is presented separately. The corresponding therapeutic options and their contraindications are discussed in the concluding chapter. The importance of interdisciplinary cooperation in related fields is emphasized.

Personal relative deprivation associated with functional disorders via stress: An examination of fibromyalgia and gastrointestinal symptoms.

BackgroundPersonal relative deprivation is a negative social comparison process typified by self-comparison, negative appraisal, and resultant negative emotionality. Personal relative deprivation has been associated with poorer physical and mental health in several domains. It has been hypothesized that the deprivation-health link operates through a stress pathway. Stress has been specifically implicated in the onset and maintenance of functional disorders, including fibromyalgia and functional gastrointestinal disorders. Despite the theoretical links between personal deprivation, stress, and functional disorders, researchers have not assessed relationships between these variables.MethodsWe recruited community participants (n = 517; 54.9% female) to examine whether personal relative deprivation can account for variance in fibromyalgia and functional gastrointestinal symptoms beyond known demographic correlates of physical health. We also examined whether the relationships between personal relative deprivation and functional disorder symptoms are mediated by stress.ResultsConsistent with our hypotheses, personal relative deprivation accounted for symptom variance in fibromyalgia and functional gastrointestinal disorders beyond that accounted for by demographic variables alone. Further, self-reported stress was found to mediate relationships between personal relative deprivation and fibromyalgia and gastrointestinal symptoms.ConclusionsThe current results support biopsychosocial models of physical health and suggest that, for patients presenting with functional disorders symptoms, a combination of biological and psychosocial interventions may be warranted.

Functional urological disorders: a sensitized defence response in the bladder-gut-brain axis.

Functional urological and gastrointestinal disorders are interrelated and characterized by a chronic course and considerable treatment resistance. Urological disorders associated with a sizeable functional effect include overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Poor treatment outcomes might be attributable to untreated underlying psychological and psychiatric disorders, as the co-occurrence of functional urological and gastrointestinal disorders with mood and anxiety disorders is common. The hypothetical bladder-gut-brain axis (BGBA) is a useful framework under which this interaction can be studied, suggesting that functional disorders represent a sensitized response to earlier threats such as childhood adversity or previous traumatic events, resulting in perceived emotional and bodily distress - the symptoms of functional disorders. Psychological and physical stress pathways might contribute to such alarm falsification, and neuroticism could be a risk factor for the co-occurrence of functional disorders and affective conditions. Additionally, physical threat - either from external sources or internal sources such as infection - might contribute to alarm falsification by influencing body-brain crosstalk on homeostasis and, therefore, affecting mood, cognition, and behaviour. Multidisciplinary research and an integrated care approach is, therefore, required to further elucidate and remediate functional urological and gastrointestinal polymorphic phenotypes.

Evaluation of the condylar position in subjects with signs and symptoms of functional disorders of the temporomandibular joint through images made with cone beam computed tomography on the sagittal plane

ABSTRACT: The aim of the study was to investigate the condylar position within the articular cavity in patients with temporomandibular disorders with signs and symptoms of functional articular disorders through images made with cone beam computed tomography (CBCT) on the sagittal plane. Methods: CBCT temporomandibular joints images of 62 patients (13 men and 49 women, average age, 39.7 years) with signs and symptoms intra-articular diagnosed by the Craniomandibular index were analyzed using the measurement method recommended by Kawamura and Ikeda (2009). We obtained the linear measures of posterior space (PS), superior space (SS), and the anterior space (AS) to determine the condyle position for each joint. Results: The average of the measurements of PS, SS, were respectively 1.9 mm (DP 0.5), 3.1 mm (DP 0.9), and 2.0 mm (DP 1.0). Conclusion: This study found that the subjects with intra-articular TMD when compared with the excellent condylar relationship established by Ikeda and Kawamura (2009) presented a more posterior and inferior condylar position.

Enteric alpha-2 adrenoceptors: Pathophysiological implications in functional and inflammatory bowel disorders

The gastrointestinal tract is innervated by extrinsic noradrenergic nerves which regulate various digestive functions, including mucosal secretions, bowel propulsion and gut sensations, via activation of α 2-adrenoceptors. These receptors are mostly involved in the prejunctional modulation of enteric neurotransmission, but they act also at extra-neural postjunctional sites. α 2-Adrenoceptor population consists of distinct subtypes, designated as α 2A, α 2B and α 2C, endowed with different physiological and pharmacological properties, and the attempts to classify α 2-adrenoceptors at gastrointestinal level have indicated a large predominance of α 2A subtypes. Studies in humans have shown a favourable influence of α 2-adrenoceptor activation on colonic tone and sensation, and there is clinical evidence indicating that α 2-agonists can improve intestinal functions and induce a satisfactory relief of symptoms in patients with irritable bowel syndrome. In addition, genetic investigations have highlighted significant associations of α 2-adrenoceptor gene polymorphisms with constipation and somatic symptoms in functional disorders of lower digestive tract. Post-operative ileus is a common surgical complication characterized by severe alteration of gut motility, resulting mainly from neurogenic and inflammatory mechanisms. Experiments in models of post-operative ileus have demonstrated an intense expression of α 2-adrenoceptors in monocytes recruited into the intestinal muscularis, and provided consistent evidence that these receptors promote post-operative gut dysfunctions by hampering enteric neurotransmission and contributing to local inflammatory reaction. Changes in the enteric nervous system are being increasingly recognized also as major determinants of digestive symptoms associated with bowel inflammation. In this regard, studies based on functional and molecular approaches concur in suggesting that the expression of enteric α 2-adrenoceptors is up-regulated in the presence of intestinal inflammation, and that α 2-mediated mechanisms are responsible for gut motor alterations occurring at both inflamed and non-inflamed sites. The present review discusses pathophysiological implications of enteric α 2-adrenoceptors, in the attempt to highlight potential therapeutic applications for drugs targeted on these receptors.

Diagnostic approach to suspected irritable bowel syndrome

Diagnostic activity in patients with suspected irritable bowel syndrome (IBS) should be brief and focussed, limited to investigations that are likely to exclude serious alternative diagnoses and when negative support a positive diagnosis of IBS. The diagnosis of IBS is clinical, and is robust over time, although other symptoms may add to the clinical picture and other symptoms of functional disorders are common. The most important differential diagnoses are celiac disease, colorectal carcinoma and colitis. ‘Red Flag’ symptoms and signs should be considered indications for full colonoscopy, which should be performed with a low threshold in patients above 50 years of age. Serologic markers are useful to exclude celiac disease, but positive tests must be confirmed with duodenal biopsies.

Chapter 29 Towards an integrative model of irritable bowel syndrome

It is being increasingly recognized that a significant amount of human suffering, medical costs, and general loss of productivity can be attributed to what traditionally has been labeled “functional” medical disorders or syndromes. Symptoms of functional disorders may appear in almost any organ system and take a variety of forms, but most common are symptoms of pain, discomfort, and loss of vitality. Functional disorders are characterized by the lack of a detectable organ lesion to account for these symptoms, which can vary from mild and infrequent to severe, continuous, and disabling. Biobehavioral models of chronic medical conditions have as their goal the integration of cognitive, behavioral, and neuroscience perspectives. While it is generally accepted that all chronic and uncomfortable conditions can in theory, be better understood if a multifactor approach is taken, it is much more difficult to describe specifically the mechanisms by which cognitive, affective and sensory processes produce symptoms and complex behaviors such as disability. This chapter discusses the application of such an integrative approach to one common functional disorder, irritable bowel syndrome. This chapter: (a) briefly reviews evidence that links psychological, colonic motor activity, and visceral sensory processes individually with the development and maintenance of IBS symptoms, (b) describes the use of evolving human experimental paradigms to study visceral psychophysiology in IBS, (c) based on recent findings, presents a preliminary biobehavioral model of IBS, which integrates neurophysiological, perceptual, and behavioral processes, and (d) describes how psychological and physiological treatment approaches can be integrated into this model.

Mandibular dysfunction in adulthood in relation to morphologic malocclusion at adolescence.

The purpose of this 20-year follow-up study was to assess whether pronounced morphologic traits of malocclusion, persisting from adolescence to about 35 years of age, imply an increased risk of persistent and severe mandibular dysfunction. In 1965-66 malocclusion was recorded in 176 adolescents; in 1981 these persons responded to a questionnaire concerning symptoms of functional disorders, and in 1986-87 malocclusion and signs of dysfunction were registered. Highly significant associations were observed between some of the self-reported symptoms and the signs registered 5-6 years later. Spearman correlation coefficients between the persistent traits of malocclusion, occurring at both examinations, and the signs of mandibular dysfunction were low in general. No association was found between the most severe and persistent functional disorders and any particular malocclusion. It is concluded that orthodontic screening of morphologic malocclusion in childhood would seem of limited value in attempts to predict mandibular dysfunction in adulthood.

A clinical and electromyographic study of the long‐term effects of an occlusal splint on the temporal and masseter muscles in patients with functional disorders and nocturnal bruxism

The postural activity of the temporal and masseter muscles in thirty-one patients with signs and symptoms of functional disorders were studied: before, during and after 3-6 months of occlusal splint therapy. The fluctuating signs and symptoms, as well as the postural activity of the temporal and masseter muscles were significantly reduced after treatment. Further, the coefficients of correlation within pairs of postural activity of the right and left muscles increased significantly. After cessation of the splint therapy the signs and symptoms recurred to the pre-treatment level within 1-4 weeks in about 80% of the patients. The results indicate that an occlusal splint can eliminate or diminish signs and symptoms of functional disorders and re-establish symmetric and reduced postural activity in the temporal and masseter muscles, which can facilitate procedures, such as functional analysis and occlusal adjustment.

Relation between functional disturbances of the masticatory system and some anthropometric, physiological and psychological variables in young Swedish men

The relation between functional disturbances of the masticatory system and anthropometric, physiological and psychological variables was studied in 248 Swedish men, aged 18-25 years. No physiological variables and only a few anthropometric variables were found to be correlated with symptoms of functional disorders or to the state of the dentition. Thus, for example, face height was greater in the presence than in the absence of disturbances of the occlusion (mainly occlusal interferences). The psychological variables were found to be most closely correlated with symptoms of functional disorders and the state of the dentition. Men with clinical dysfunction had a lower general level of intelligence than men without. Social adaptation at school was poor in those who reported parafunctions. Men with parafunctions, frequent headache, general muscle and joint symptoms and balancing side interferences had low emotional stability compared with those without such symptoms. Individuals completely free from symptoms of functional disturbances had high emotional stability.