The Curbsiders Internal Medicine Podcast REBOOT: #334 IBS, Functional Dyspepsia, and Cyclic Vomiting: Disorders of Gut Brain Interaction (DGBI)
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Jan 1, 2024 Dr. Xiao Jing (Iris) Wang from Mayo Clinic joins to discuss disorders of the Gut-Brain Interaction (DGBI), including IBS, functional dyspepsia, and cyclic vomiting. Topics include diagnostic criteria and treatments for functional dyspepsia, testing algorithms and treatments for irritable bowel disease, and diagnosis and management of cyclic vomiting syndrome and cannabis hyperemesis syndrome.
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Listen First, Test Sparingly
- When seeing suspected DGBI, listen closely and validate symptoms before ordering tests.
- Reassure patients that limited testing doesn't mean symptoms are dismissed.
Trainee Anxiety Over Functional GI Patients
- Dr. Wang reflected that trainees often feel anxious about these patients because they aren't taught these disorders much.
- She noted the diseases rarely kill, so they get less emphasis in inpatient training.
Limit IBS Testing To High-Yield Tests
- For IBS-D test celiac serologies and fecal calprotectin to exclude organic disease.
- Reserve pathogen testing for high-risk post-infectious cases and tailor further GI testing if symptoms persist.