User:Twestall/Multi-Dimensional Clinical Profile

Multi-Dimensional Clinical Profile (MDCP) The use of the Rome Criteria to diagnose a functional GI disorder (FGID) is helpful for selecting patients in clinical trials and may be of some value in clinical identification. However, these criteria are categorical (i.e., having a diagnosis or not) and do not capture the full dimensionality of the patient’s illness state in a manner that can direct targeted treatment. For example a patient with IBS-D having mild and occasional symptoms of abdominal discomfort and loose stools and functioning without impairment would be treated quite differently than a patient with the same diagnosis having continuous severe and disabling pain, and co-morbid anxiety disorder with fears of incontinence when leaving the house. The MDCP identifies these clinical components and categorizes them within a biopsychosocial framework that is targeted to the needs of the individual. The five components of this framework include the Rome diagnosis (Category A), subclassification of the diagnosis that can lead to more specific treatments (e.g., IBS-D or IBS-C, SOD I or SOD II, EPS or PDS), the personal impact of the disorder on the patient (Category C), psychosocial influences (Category D), and physiological features and biomarkers (Category E). This framework is intuitively clear and the organizational approach is both pragmatic and useful. Physicians can use this information to choose from treatment options specific to each patient's clinical profile The MDCP book is the result of a 3-year iterative process among experts in FGIDs, members of the Foundation’s Board of Directors who developed an extensive database for the reader to use in creating the patient’s clinical profile. Using 32 case histories the book takes the reader through the variety of FGIDs and uses the clinical data to create the patient’s profile which then leads to up to date and well referenced treatments. This book will be of use to gastroenterologists and primary care providers as well as students, residents and fellows involved in the care of patients with FGIDs.