Victor Chaban

By Victor Chaban

Part of the book: Endometriosis

By Victor V. Chaban

A functional disorder is a medical condition that impairs the normal function, but without major organic cause such as irritation or inflammation and where the organ or part of the body looks completely normal under medical examination. The accumulation of abnormalities that limit body functions is a major risk factor for patients with irritable bowel syndrome (IBS), defined as a gastrointestinal disorder with abdominal pain or discomfort that is associated with a change in bowel habit. Often, this disorder is accompanied by the concomitant decline in cognitive or motor performance. Pain that in some patients is out of proportion to identifiable pathology is the most immediate and dramatic consequence of IBS and is responsible for a highly negative impact on quality of life and substantial workforce loss. For patients with IBS, the most common comorbid diagnoses include painful bladder syndrome (PBS) or chronic pelvic pain (CPP). Cells of the affected tissues may interact in cell-to-cell manner messages through the transfer of hormones, cytokines, and other mediators that influence normal functioning. The complex interplay and balance between these diverse mediators, ageing, genetic background, and environmental factors may ultimately determine the outcome of the progression of the functional disorder. On a cellular level, these responses are highly complex, involving a vast array of enzymes and receptors of virtually every class, directing recruitment of many types of cells to recover the healthy state. Indeed, a balance between the messengers with the inherent redundancy of the different body systems makes therapeutic intervention of functional disorders a considerable challenge.

Part of the book: Irritable Bowel Syndrome

By Victor V. Chaban

Chronic visceral pain is the most common complication of many functional disorders that do not have a defined pathophysiological cause. Functional pain syndromes include common disorders, such as irritable bowel syndrome (gastroenterology), chronic pelvic pain (gynecology), interstitial cystitis/painful bladder syndrome (urology), fibromyalgia (rheumatology), across multiple medical disciplines. Patients suffering from functional diseases may progress to cognitive decline and depression through neuroplastic changes not only at the level of the central nervous system but also in the periphery. Moreover, most functional diseases are much more prevalent in women than men suggesting estrogen modulation of nociceptive pathways. Defining the etiology of functional diseases for possible therapeutic interventions will have a significant impact on our understanding of observed gender differences and on improving patient’s quality of life.

Part of the book: Neuroplasticity