Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2020; 26(26): 3712-3719
Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3712
Functional gastrointestinal disorders in inflammatory bowel disease: Time for a paradigm shift?
Dipesh H Vasant, Alexander C Ford
Dipesh H Vasant, Gastroenterology, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester M23 9LT, United Kingdom
Dipesh H Vasant, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester M23 9LT, United Kingdom
Alexander C Ford, Leeds Institute of Medical Research at St. James’s, University of Leeds, Leeds LS9 7TF, United Kingdom
Alexander C Ford, Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, United Kingdom
Author contributions: Vasant DH and Ford AC both reviewed the literature; Vasant DH wrote the paper; Ford AC reviewed and helped write the paper, and provided important intellectual input.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: Dipesh H Vasant, MBChB, MRCP, PhD, Senior Lecturer, Gastroenterology, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, United Kingdom. dipesh.vasant@mft.nhs.uk
Received: March 28, 2020
Peer-review started: March 28, 2020
First decision: April 18, 2020
Revised: April 23, 2020
Accepted: July 1, 2020
Article in press: July 1, 2020
Published online: July 14, 2020
Core Tip

Core tip: Functional gastrointestinal symptoms, in the absence of inflammation, affect around one-third of inflammatory bowel disease (IBD) patients in remission, causing significant psychological distress and impairment of quality of life. As IBD therapies continue to advance, functional gastrointestinal symptoms, as a consequence of previous inflammation, are set to become a bigger problem. Here, we review the current evidence base, highlight a recently proposed diagnostic algorithm, and discuss empirical treatment guidance for functional gastrointestinal symptoms in quiescent IBD. We also discuss future considerations and areas of unmet need to stimulate further research.