The Second Annual AGA Institute – Rome Foundation Lectureship at Digestive Disease Week 2009

Juan-R Malagelada, M.D.

The Rome Foundation and the American Gastroenterological Association (AGA) were pleased to present their 2nd annual lectureship at Digestive Diseases Week (DDW). The lectureship was designed to address broad aspects of health care that are relevant to digestive diseases and the functional GI disorders. This year’s speaker was Juan-R Malagelada, M.D., President UEGW 2008 who presented a lecture on:

 
 

“Motility Assessments for Functional GI Disorders: How far does it get us?”

The lecture focused on a key practice issue: whether functional disorders truly represent disturbed gut function and whether gut motility assesment by current technologies is potentially useful in the clinical setting.

Today, the diagnosis of functional disorders is mainly established on the basis of symptom analysi. By contrast, the lecturer argued that we should strive to diagnose the underlying disease mechanisms and shape the therapy accordingly.

To defend his recommended approach, the lecturer reviewed what we know about pathophysiological abnormalities associated or accounting for the patient’s abdominal symptoms and described the advanced methodologies now available to assess such abnormalities. He also addressed the clinical application of the new technology, particularly in patients with severe, protracted and drug-refractory symptoms.

The message of the lecture was that gastroenterologists should learn a “third way” to approach patients with unexplained abdominal symptoms : neither ceasely repeat imaging tests to discard so called organic lesions nor suscinctly symptom-label illnesses or provide psychological explanations. A degree of technification of our practices to measure and report measurable disturbances in gut function is needed to unlock forward our referal clinics, satisfy patient’s expectations and rationally structure disease management.