Functional gastrointestinal (GI) and motility disorders generate a large volume of consultations in gastroenterology and primary care offices. The present article summarizes the most interesting studies presented in the annual meeting of the American Gastroenterological Association 2008. For all functional GI disorders, studies were presented that evaluated the applicability of diagnostic criteria in clinical practice and new data were presented on physiopathology (for example, mediation by
neuromodulators such as
serotonin, microinflammation, alterations in intestinal microbiota, and psychological factors). More specifically, the therapeutic results of new prokinetic agents in functional
dyspepsia, such as
acotiamide, were presented. This agent has been demonstrated to have good efficacy in symptom control, especially in patients with postprandial distress syndrome. In
irritable bowel syndrome, data were presented on several drugs that act through diverse mechanisms of action and have been shown to be more effective than placebo in symptom control. These drugs include
antiinflammatory agents such as
mesalazine,
antibiotics such as
rifaximin, probiotics with distinct bacterial strains, and prokinetic agents such as
lubiprostone. Highly promising results have been obtained in the treatment of
constipation with prokinetics such as
prucalopride and with novel laxatives such as
linaclotide, as well as with techniques that continue to be shown to be effective such as anorectal
biofeedback, which is also highly useful in patients with
fecal incontinence. Another disorder that is less frequent but highly difficult to treat is
gastroparesis. For several years, treatment in the most severe cases has consisted of implantation of a gastric pacemaker. Although the results are far from perfect, new data were presented that allow better patient selection to achieve greater symptom control. The list of new advances, both in knowledge of the physiopathology of these disorders and on their treatments, is extensive. Consequently, 2008 has been a good year in terms of the useful information gathered for physicians interested in functional GI and
motor disorders.