Minireviews
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2019; 25(10): 1185-1196
Published online Mar 14, 2019. doi: 10.3748/wjg.v25.i10.1185
Personalized medicine in functional gastrointestinal disorders: Understanding pathogenesis to increase diagnostic and treatment efficacy
Xiao Jing Wang, Michael Camilleri
Xiao Jing Wang, Michael Camilleri, Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: The authors contributed equally to writing and revising the manuscript. Wang XJ and Camilleri M drafted and finalized the manuscript.
Conflict-of-interest statement: The authors have declared no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Michael Camilleri, MD, Doctor, Professor, Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905, United States. camilleri.michael@mayo.edu
Telephone: +1-507-2662305
Received: January 17, 2019
Peer-review started: January 18, 2019
First decision: January 30, 2019
Revised: February 4, 2019
Accepted: February 22, 2019
Article in press: February 23, 2019
Published online: March 14, 2019
Core Tip

Core tip: Functional gastrointestinal disorders (FGIDs) are associated with mechanisms that constitute important targets for personalized treatment. Patients with upper gastrointestinal (GI) symptoms may have delayed gastric emptying (GE), reduced gastric accommodation (GA), both impaired GE and GA, or neither. Treatments targeted to the underlying pathophysiology utilize prokinetics, gastric relaxants, or central neuromodulators. Patients with functional lower GI symptoms may have constipation-predominant irritable bowel syndrome, pelvic floor dyssynergia, colonic inertia, diarrhea-predominant irritable bowel syndrome, bile acid diarrhea, or disaccharidase or sucrose-isomaltase deficiency. Personalization is applied through pharmacogenomics related to drug pharmacokinetics, specifically the role of CYP2D6, 2C19 and 3A4. The time for personalized treatments of FGIDs is here.