Practical Treatment for Patients with Functional Esophageal Disorders(<Special Issue>Psychosomatic Approach of Gastrointestinal Disorders)

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  • 機能性食道疾患診療の実際(<特集>心身医学と消化器症状)
  • 機能性食道疾患診療の実際
  • キノウセイ ショクドウ シッカン シンリョウ ノ ジッサイ

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Abstract

Main symptoms of functional esophageal disorders are heartburn, chest pain, dysphagia. They consist of mainly esophageal motility disorders, gastroesophageal reflux disease (GERD), non-cardiac chest pain (NCCP), but they are often overlapped each other. The first diagnosis needs to exclude gastrointestinal structural disorders, metabolic disorders and ischemic heart diseases. Additionally, a functional diagnosis is defined by esophageal X ray (Barium swallow), esophageal manometry, 24-hr ambulatory esophageal pH monitoring, and provocative tests. The Rome III classification system in functional esophageal disorders doesn't work well in clinical practice. It is not only clinically but psychosomatically useful to use 'dyspepsia' as the generalized symptoms-term of the upper functional gastrointestinal disorders (FGID) including the esophageal disorders. In treating FGID patients, management is largely empirical and we should consider their psychosocial factors, behaviors and "the meaning" of their symptoms.

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