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There is a well-established opinion among gastroenterologists from all nations that functional GI disorders and irritable bowel syndrome are the most common diagnoses made in GI clinics and yet represent some of the most challenging patients to manage. The medical mind set is to establish a diagnosis through history, examination and diagnostic tests and to come up with a clear organic explanation for GI disorders. Unfortunately in functional GI disorders, this pathway is often fraught with pitfalls and difficulties and frequently results in endless investigations and fruitless end outcomes for patients in whom no clear organic pathology can be found. Despite all this, it has been known for centuries that there exist people who present with disturbance of gut function without explanation. Such patients remained somewhat of an enigma in those times, but we would now recognise them as having functional GI disorders such as irritable bowel syndrome.1
In order to attempt to better characterise and indeed provide better …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.