Cross-Functional Syndrome of Gastrointestinal Diseases in Adults and Children in the Context of Their Continuity

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This review provides an analysis of a possible relationship between functional diseases of the gastrointestinal tract in children and adults. Some functional disorders previously identified only in the children’s age group, such as abdominal migraine, were increasingly recorded in the adult population. As a rule, the diagnosis of functional gastrointestinal diseases is based primarily on clinical symptoms. However, researchers increasingly note that for some pathologies in children, such as gastroesophageal reflux disease, the main symptoms of reflux, such as heartburn and belching, are not absolutely dominant. All this makes it possible to express an opinion on the formation of a universal functional pathology of the digestive tract with the dominance at certain stages of the pathological process of one or another symptomatology that affects the central nervous system.

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Igor' V. Maev

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

ORCID iD: 0000-0001-6114-564X
SPIN-code: 1994-0933
Scopus Author ID: 550426

MD, PhD, Professor, Academician of the RAS

Russian Federation, 2, bld. 4, Bolshaya Pirogovskaya str., 119435, Moscow

Maksim M. Osadchuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0002-8417-5849
SPIN-code: 3373-5500
Scopus Author ID: 790039

PhD, Assistant Professor

Russian Federation, 2, bld. 4, Bolshaya Pirogovskaya str., 119435, Moscow

Mihail A. Osadchuk

City Polyclinic No. 52 of the Moscow Department of Health

Author for correspondence.
ORCID iD: 0000-0003-0485-6802
SPIN-code: 3108-0478
Scopus Author ID: 671330

MD, PhD, Professor

Russian Federation, 2, bld. 4, Bolshaya Pirogovskaya str., 119435, Moscow


  1. Keely S, Walker MM, Marks E, Talley NJ. Immune dysregulation in the functional gastrointestinal disorders. Eur J Clin Invest. 2015;45(12):1350–1359. doi:
  2. Burns G, Pryor J, Holtmann G, et al. Immune Activation in Functional Gastrointestinal Disorders. Gastroenterol Hepatol. 2019;15(10):539–548.
  3. Saito YA, Schoenfeld P, Locke GR. The epidemiology of irritable bowel syndrome in North America: A systematic review. Am J Gastroenterol. 2002;97(8):1910–1915. doi:
  4. Oshima T, Miwa H. Epidemiology of Functional Gastrointestinal Disorders in Japan and in the World. J Neurogastroenterol Motil. 2015;21(3):320–329. doi:
  5. Lewis ML, Palsson OS, Whitehead WE, van Tilburg MAL. Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents. J Pediatr. 2016;177:39–43.e3. doi:
  6. Peralta-Palmezano JJ, Guerrero-Lozano R. Prevalence of Functional Gastrointestinal Disorders in School Children and Adolescents. Korean J Gastroenterol Taehan Sohwagi Hakhoe Chi. 2019;73(4):207–212. doi:
  7. Mukhtar K, Nawaz H, Abid S. Functional gastrointestinal disorders and gut-brain axis: What does the future hold? World J Gastroenterol. 2019;25(5):552–566. doi:
  8. Palsson OS, Whitehead W, Törnblom H, et al. Prevalence of Rome IV Functional Bowel Disorders Among Adults in the United States, Canada, and the United Kingdom. Gastroenterology. 2020;158(5):1262–1273.e3. doi:
  9. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2010;8(5):401–409. doi:
  10. Hadjivasilis A, Tsioutis C, Michalinos A, et al. New insights into irritable bowel syndrome: From pathophysiology to treatment. Ann Gastroenterol. 2019;32(6):554–564. doi:
  11. Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012;107(12):1793–1801. doi:
  12. Friesen CA, Rosen JM, Schurman JV. Prevalence of overlap syndromes and symptoms in pediatric functional dyspepsia. BMC Gastroenterol. 2016;16(1):75. doi:
  13. Schurman JV, Friesen CA, Danda CE, et al. Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement. J Pediatr Gastroenterol Nutr. 2005;41(3):291–295. doi:
  14. Wang A, Liao X, Xiong L, et al. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC Gastroenterol. 2008;8:43. doi:
  15. Van Oudenhove L, Vandenberghe J, Vos R, et al. Factors associated with co-morbid irritable bowel syndrome and chronic fatigue-like symptoms in functional dyspepsia. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2011;23(6):524–e202. doi:
  16. Wouters MM, Van Wanrooy S, Nguyen A, et al. Psychological comorbidity increases the risk for postinfectious IBS partly by enhanced susceptibility to develop infectious gastroenteritis. Gut. 2016;65(8):1279–1288. doi:
  17. Halvorson HA, Schlett CD, Riddle MS. Postinfectious irritable bowel syndrome — a meta-analysis. Am J Gastroenterol. 2006;101(8):1894–1899. doi:
  18. Mearin F, Pérez-Oliveras M, Perelló A, et al. Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study. Gastroenterology. 2005;129(1):98–104. doi:
  19. Wang XJ, Camilleri M. Personalized medicine in functional gastrointestinal disorders: Understanding pathogenesis to increase diagnostic and treatment efficacy. World J Gastroenterol. 2019;25(10):1185–1196. doi:
  20. Осадчук М.А., Cвистунов А.А., Киреева Н.В., Осадчук М.М. Функциональные заболевания желудочно-кишечного тракта в контексте синдрома перекреста: современное состояние проблемы // Терапевтический архив. — 2020. — Т. 92. — № 2. — С. 112–118. [Osadchuk MA, Cvistunov AA, Kireeva NV, Osadchuk MM. Funkcional’nye zabolevaniya zheludochno-kishechnogo trakta v kontekste sindroma perekresta: sovremennoe sostoyanie problemy. Terapevticheskij Arhiv. 2020;92(2):112–118. (In Russ.)] doi:
  21. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308–328. doi:
  22. Haag S, Talley NJ, Holtmann G. Symptom patterns in functional dyspepsia and irritable bowel syndrome: Relationship to disturbances in gastric emptying and response to a nutrient challenge in consulters and non-consulters. Gut. 2004;53(10):1445–1451. doi:
  23. Yarandi SS, Christie J. Functional Dyspepsia in Review: Pathophysiology and Challenges in the Diagnosis and Management due to Coexisting Gastroesophageal Reflux Disease and Irritable Bowel Syndrome. Gastroenterol Res Pract. 2013;2013:351086. doi:
  24. Осадчук М.А., Осадчук М.М. Синдром перекреста функциональной диспепсии, гастроэзофагеальной рефлюксной болезни и синдрома раздраженного кишечника: оптимизация терапии // Русский медицинский журнал. — 2015. — № 28. — С. 1690–1692. [Osadchuk MA, Osadchuk MM. Sindrom perekresta funkcional’noj dispepsii, gastroezofageal’noj reflyuksnoj bolezni i sindroma razdrazhennogo kishechnika: Optimizaciya terapii. Russkij Medicinskij Zhurnal. 2015;28:1690–1692. (In Russ.)]
  25. Kuriyama M, Kato J, Morimoto N, et al. Specific gastroduodenoscopic findings in Crohn’s disease: Comparison with findings in patients with ulcerative colitis and gastroesophageal reflux disease. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2008;40(6):468–475. doi:
  26. Theisen J, Nehra D, Citron D, et al. Suppression of gastric acid secretion in patients with gastroesophageal reflux disease results in gastric bacterial overgrowth and deconjugation of bile acids. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2000;4(1):50–54. doi:
  27. Walker MM, Talley NJ. Review article: bacteria and pathogenesis of disease in the upper gastrointestinal tract — beyond the era of Helicobacter pylori. Aliment Pharmacol Ther. 2014;39(8):767–779. doi:
  28. Yang L, Lu X, Nossa CW, et al. Inflammation and intestinal metaplasia of the distal esophagus are associated with alterations in the microbiome. Gastroenterology. 2009;137(2):588–597. doi:
  29. Venkova K, Johnson AC, Myers B, Greenwood-Van Meerveld B. Exposure of the amygdala to elevated levels of corticosterone alters colonic motility in response to acute psychological stress. Neuropharmacology. 2010;58(7):1161–1167. doi:
  30. Vicario M, Alonso C, Guilarte M, et al. Chronic psychosocial stress induces reversible mitochondrial damage and corticotropin-releasing factor receptor type-1 upregulation in the rat intestine and IBS-like gut dysfunction. Psychoneuroendocrinology. 2012;37(1):65–77. doi:
  31. Folks DG. The interface of psychiatry and irritable bowel syndrome. Curr Psychiatry Rep. 2004;6(3):210–215. doi:
  32. Collins SM, Surette M, Bercik P. The interplay between the intestinal microbiota and the brain. Nat Rev Microbiol. 2012;10(11):735–742. doi:
  33. Bailey MT, Coe CL. Maternal separation disrupts the integrity of the intestinal microflora in infant rhesus monkeys. Dev Psychobiol. 1999;35(2):146–155.
  34. Akiho H, Ihara E, Nakamura K. Low-grade inflammation plays a pivotal role in gastrointestinal dysfunction in irritable bowel syndrome. World J Gastrointest Pathophysiol. 2010;1(3):97–105. doi:
  35. Corsetti M, Caenepeel P, Fischler B, et al. Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia. Am J Gastroenterol. 2004;99(6):1152–1159. doi:
  36. Boles RG, Zaki EA, Kerr JR, et al. Increased prevalence of two mitochondrial DNA polymorphisms in functional disease: Are we describing different parts of an energy-depleted elephant? Mitochondrion. 2015;23:1–6. doi:
  37. Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: Child/adolescent. Gastroenterology. 2006;130(5):1527–1537. doi:
  38. Vandenplas Y, Rudolph CD, Di Lorenzo C, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2009;49(4):498–547. doi:
  39. Turco R, Russo M, Martinelli M, et al. Do Distinct Functional Dyspepsia Subtypes Exist in Children? J Pediatr Gastroenterol Nutr. 2016;62(3):387–392. doi:
  40. Baran M, Cagan Appak Y, Karakoyun M, et al. The overlap of gastroesophageal reflux disease and functional constipation in children: the efficacy of constipation treatment. Eur J Gastroenterol Hepatol. 2017;29(11):1264–1268. doi:
  41. Eusebi LH, Ratnakumaran R, Yuan Y, et al. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut. 2018;67(3):430–440. doi:
  42. Singendonk M, Goudswaard E, Langendam M, et al. Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children: A Systematic Review. J Pediatr Gastroenterol Nutr. 2019;68(6):811–817. doi:
  43. Peery AF, Crockett SD, Murphy CC, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology. 2019;156(1):254—272.e11. doi:
  44. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: A global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900–1920. doi:
  45. Маев И.В., Бусарова Г.А., Андреев Д.Н. Болезни пищевода. — М.: ГЭОТАР-МЕДИА, 2019. — 646 с. [Maev IV, Busarova GA, Andreev DN. Bolezni pishchevoda. Moscow: GEOTAR-MEDIA; 2019. 646 р. (In Russ.)]
  46. Aziz Q, Fass R, Gyawali CP, et al. Functional Esophageal Disorders. Gastroenterology. 2016;150(6):1368—1379. doi:
  47. Mahoney LB, Rosen R. The Spectrum of Reflux Phenotypes. Gastroenterol Hepatol. 2019;15(12):646–654.
  48. Gupta SK, Hassall E, Chiu Y-L, et al. Presenting symptoms of nonerosive and erosive esophagitis in pediatric patients. Dig Dis Sci. 2006;51(5):858–863. doi:
  49. Nelson SP, Chen EH, Syniar GM, Christoffel KK. Prevalence of symptoms of gastroesophageal reflux during childhood: A pediatric practice-based survey. Pediatric Practice Research Group. Arch Pediatr Adolesc Med. 2000;154(2):150–154. doi:
  50. Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2018;66(3):516–554. doi:
  51. Buie T, Campbell DB, Fuchs GJ, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: A consensus report. Pediatrics. 2010;125(Suppl 1):S1–18. doi:
  52. Volkmar F, Siegel M, Woodbury-Smith M, et al. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2014;53(2):237–257. doi:
  53. Schneider T, Przewłocki R. Behavioral alterations in rats prenatally exposed to valproic acid: Animal model of autism. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2005;30(1):80–89. doi:
  54. The Centers for Disease Control and Prevention (CDC) Autism spectrum disorder prevalence [database on the Internet] 2014. Available from:
  55. De Palma G, Collins SM, Bercik P, Verdu EF. The microbiota-gut-brain axis in gastrointestinal disorders: Stressed bugs, stressed brain or both? J Physiol. 2014;592(14):2989–2997. doi:
  56. Mayer EA, Tillisch K. The brain-gut axis in abdominal pain syndromes. Annu Rev Med. 2011;62:381–396. doi:
  57. Lackner JM, Brasel AM, Quigley BM, et al. The ties that bind: perceived social support, stress, and IBS in severely affected patients. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2010;22(8):893–900. doi:
  58. Napthali K, Koloski N, Talley NJ. Abdominal migraine. Cephalalgia Int J Headache. 2016;36(10):980–986. doi:
  59. Di Stefano M, Pucci E, Miceli E, et al. Prevalence and pathophysiology of post-prandial migraine in patients with functional dyspepsia. Cephalalgia Int J Headache. 2019;39(12):1560–1568. doi:
  60. Le Gal J, Michel J-F, Rinaldi VE, et al. Association between functional gastrointestinal disorders and migraine in children and adolescents: A case-control study. Lancet Gastroenterol Hepatol. 2016;1(2):114–121. doi:

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