Key Points
4
Figure 2. Conceptual Framework to Explain FBDs
e functional bowel disorders (FBDs) are classified into 5 distinct categories: IBS,
FC, functional diarrhea (FDr), functional abdominal distention/functional abdominal
distention (FAB/FAD), and unspecified FBD (U-FBD). Although oen thought of as
existing as completely separate and discrete disorders, it is important to acknowledge that
significant overlap exists between these disorders. ese disorders should be thought of as
existing on a continuum, rather than in isolation. is figure illustrates that a patient with
IBS (right) will have symptoms of abdominal pain, in contrast to a patient with FC or
FDr, who does not have abdominal pain. Bloating and distention are common symptoms
frequently reported by patients with any FBD.
GRADE Strength of Recommendations and Implications
Grade
Implications of strong and conditional (weak)
guideline recommendations
Strong • Patients: Most individuals in this situation would want the
recommended course of action and only a small proportion would
not.
• Clinicians: Most individuals should receive the recommended
course of action. Formal decision aids are not likely to be needed
to help individuals make decisions consistent with their values
and preferences.
Conditional
(weak)
• Patients: The majority of individuals in this situation would want
the suggested course of action, but many would not.
• Clinicians: Different choices will be appropriate for different
patients. Decision aids may well be useful in helping individuals
making decisions consistent with their values and preferences.
Clinicians should expect to spend more time with patients when
working toward a decision.
Reprinted with permission from Sultan et al. Clin Gastroenterol Hepatol. 2013;11:329–332.
Constipation
Diarrhea
