GIOVANNA NICOTRA

EPO srl Istituto Farmochimico Fitoterapico, Via Stadera 19, Milan, 20141, Italy

Abstract

Functional gastrointestinal disorders (FGIDs) can be defined as an impairment of the normal function of the gastrointestinal (GI) tract with no obvious cause. FGIDs include many chronic disorders, showing a peculiar periodicity in frequency and severity; functional dyspepsia (FD), irritable bowel syndrome (IBS), constipation and oesophageal disorders are the most common. Anxiety is widely recognized as an exacerbating factor for FGIDs.
According to many sources, FGIDs affect about one fourth of the population in western countries, with serious repercussions on the quality of life of patients; despite of this, FGIDs can be regarded as hidden pathologies, since many affected people don’t even seek medical attention or, when they do so, the symptoms may be underestimated or misdiagnosed, due to the complexity of this kind of disturbances and to the embarrassment of the patients in reporting them (especially in case of bowel disorders). In addition, available pharmacological treatments for FGIDs sometimes fail, therefore more and more patients turn their attention towards complementary and alternative medicine (CAM). Herbal medicine (phytotherapy), dietary therapy, supplementation with probiotics, mind-body therapies (i.e. meditation and hypnosis), breathing exercises (i.e. yoga), somatic therapies (i.e. acupuncture, massage) are the most common and promising CAM treatments, that can be also combined, according to an individualized approach to the patient.
Being both FGIDs and CAM very wide subjects, this article will focalize on a very limited part of them, namely the phytotherapy of FD.

INTRODUCTION

The acronym FGIDs refers to a miscellaneous group of abdominal disturbances, which are not due to structural or biochemical abnormalities and cannot be diagnosed by endoscopy, x-ray, or laboratory tests; for this reason FGIDs are classified by the organ of involvement. FD, also called non-ulcer dyspepsia, is one of the most common, affecting 70 percent of patients with dyspepsia (1). The term “dyspepsia” comes from the Greek “δγς-” (“dis-“), a prefix indicating negation, and “π?ψ?” (“pepsé” meaning “digestion”) and can be translated as “indigestion” (2); the evidence that many dyspeptic patients have meal-related symptoms accounts for it.
According to the widely recognized Rome III diagnostic criteria, FD must include one or more following symptoms (3):

• bothersome postprandial fullness
• early satiation
• epigastric pain
• epigastric burning

with no evidence of structural disease (including at upper endoscopy), that is likely to explain the symptoms; the criteria should be fulfilled for the last 3 months with symptom onset at least 6 months p ...