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Functional Bowel Disorders: A Roadmap to Guide the Next Generation of Research

2017; Elsevier BV; Volume: 154; Issue: 3 Linguagem: Inglês

10.1053/j.gastro.2017.12.010

1528-0012

Lin Chang, Carlo Di Lorenzo, Gianrico Farrugia, Frank A. Hamilton, Gary M. Mawe, Pankaj J. Pasricha, John Wiley,

Diet and metabolism studies

A successful approach to advancing FBD research will include the following strategies:•Performance of vertically integrated studies in relevant animal models and stratified populations of human subjects. Include males and females in the experimental design.•Elucidation of the bidirectional afferent and efferent pathways and the timing of changes in relevant CNS regions, spinal and enteric pathways, and correlation with specific clinical phenotypes and behavioral end points.•Establishment of a robust data repository linked to a parallel biorepository with standardized specimen collection and storage. These resources should be validated, shareable, and include relevant control populations.•Identification, validation, and testing of novel biomarkers for diagnosis and treatment.•Application of innovative technologies in preclinical and clinical research. Examples include integrated -omics technologies, functional imaging at the cellular and in vivo levels, and gene editing. Dedicated bioinformatics expertise should be available to ensure effective use of the data repository and biorepository for -omics−based research.•Assessment of value and reproducibility at the preclinical and clinical levels.•Development of an interdisciplinary approach to elucidate cellular mechanisms and integrated pathways and to monitor therapeutic interventions.•Performance of longitudinal studies encompassing relevant time points throughout the lifespan (animal and human studies), recognizing that the temporal expression of relevant biomarkers and clinical symptoms is dynamic.•Evaluation of multimodal therapeutic interventions that are customized for specific patient subpopulations, including pharmacologic, complementary and alternative, and behavioral interventions with the goal of developing evidence-based integrated treatments.•Initiation of relevant interventions early in life to decrease the risk of FBD development in vulnerable individuals and to improve outcomes of those who have FBDs.•Promote and assess programs aimed at improving the provider−patient relationship to optimize patient satisfaction, compliance, and symptom reduction. Evaluate the effect of these programs on health care costs.•Explore the role of web-based applications, wearable or implantable devices for gathering real-time data from individuals with FBDs.•Development of innovative, multiple-source funding models.