Analysis on Pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and Establishment of Comprehensive Evaluation Methods and Treatment of FGIDs

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1.Measurement of solid meal gastric and small intestinal transit time by the standard methods and establishment of respective simple procedure :From the results on gastric emptying (GE) and oro-cecal transit time (OCTT) measured by ^<13>C-octanoic acid (OA), ^<13>C-lactose ureide (LU) and radio-isotope method in normal volunteers, it was suggested that simultaneous measurement of GE and OCTT by ^<13>C-breath test be possible and accurate.2.Measurement of gastric perception threshold and gastric adaptive relaxation by the standard methods and establishment of respective simple procedure :Compared parameters obtained from standard barostat method with those by drink test, it was suggested that the simple method (eg, drink test) should estimate gastric perception and adaptive relaxation response.3.Effect of a drug on solid meal gastric and small intestinal transit time and rectal sensory threshold in patients with irritable bowel syndrome (IBS) :(1)^<13>C-breath test (OA & LU) was perform … More ed before and after drug (polycarbophil calcium) administration in IBS patients and normal volunteers, and the drug improved the accelerated GE in IBS.(2)The drug improved the symptoms and quality of life in diarrhea-predominant IBS patients, and in some cases rectal sensory threshold and compliance were also increased.4.Measurement of brain blood flow (BBF) under rectal balloon distension in patients with functional gastrointestinal disorders and the effect of the stressor(s) on BBF (brain-gut interaction)BBF was measured in conditions with rectal distension (mechanical stressor) and/or mental arithmetic (psychological stressor) by positron emission tomography in diarrhea-predominant IBS patients and normal volunteers. Differences in pain response to the stressor(s) and the region of increased BBF between IBS and volunteers are demonstated.5.Establishment of psychosomatic diagnosis and treatment strategy for intractable functional dyspepsia (FD) :Half of intractable FD patients were diagnosed as somatoform disorders who are resistant to ordinary drug therapy. A novel treatment strategy for those patients was proposed. Validation study should be essential. Less