Bmj Usa: Letter

RAPID RESPONSES FROM BMJ.COM: Functional confusion

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E92
  1. David L Wingate (, emeritus professor of gastroenterology
  1. Barts & London School of Medicine, London, UK
  2. Royal Victoria Hospital, Belfast, Northern Ireland, UK

    This article originally appeared in BMJ USA

    Editor—It is saddening to see perpetuation of the term “functional” as shorthand for “I don't know the nature of the problem.”

    Dyspepsia is the most common presenting gastrointestinal symptom. Dyspepsia of recent onset, sometimes accompanied by weight loss, rings alarm bells over the possibility of malignancy, and dictates the need for endoscopy, but the majority of patients do not fit this paradigm.

    The most common cause of non-malignant dyspepsia is gastroesophageal reflux. This is a true “functional” disorder in that it is a disorder of normal function; acid that should reside in the stomach is retropelled into the esophagus. …

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