Gut-Brain Axis Disorders Unit

Diagnosis and treatment of gut-brain axis disorders

The Gut-Brain Axis Disorders Unit at the Publio Cordón Memorial Hospital, which forms part of the Digestive System Department, is headed by Dr Malena García Arredondo, a highly regarded specialist in gut microbiota and the interaction between the digestive and nervous systems.

The unit is dedicated to the diagnosis and treatment of functional digestive disorders, complex conditions in which the digestive system, the immune system and the communication mechanisms between the gut and the brain interact.

A comprehensive approach to digestive disorders

The unit treats adult patients with complex functional digestive disorders, particularly those with persistent symptoms or symptoms that are difficult to interpret clinically. Its aim is to understand the true cause of the symptoms, establish an accurate functional diagnosis and determine the most appropriate treatment for each individual case.

The approach is based on a rigorous clinical assessment that incorporates analysis of the gut microbiota, the neuromuscular function of the digestive tract and abdominal wall, and the regulatory mechanisms of the gut-brain axis. The entire process is carried out over the time required to explain, discuss and reach a consensus on each therapeutic decision.

Persistent functional gastrointestinal symptoms

The unit deals with a wide range of functional digestive disorders that present with persistent and, often, debilitating symptoms, even in the absence of visible structural abnormalities on conventional tests.

Among the most common conditions are:

• Gastro-oesophageal reflux disease

• Functional heartburn and hypersensitive oesophagus

• Oesophageal motility disorders (achalasia, oesophageal spasm, ineffective motility, rumination syndrome, supraglottic belching)

• Functional dyspepsia and gastroparesis

• Irritable bowel syndrome

• Functional abdominal distension

• Chronic abdominal pain

• Bowel rhythm disorders, such as chronic diarrhoea or chronic constipation

• Anorectal disorders, including faecal incontinence, defecatory dyssynergia or proctalgia fugax

These conditions require a detailed clinical assessment to distinguish between functional disorders and organic pathology, and to define a treatment strategy tailored to each individual case.

How treatment is assessed and decided upon

The care process begins with a detailed clinical assessment, based on listening to the patient and a systematic analysis of their pattern of symptoms. Where indicated, functional gastrointestinal tests are carried out, such as high-resolution oesophageal or anorectal manometry and functional intraluminal planimetry (FLIP), which enable the motility and distensibility of the gastrointestinal sphincters to be assessed with precision.

Treatment decisions are made in a reasoned and step-by-step manner, supported by expert judgement and the information obtained during the assessment, avoiding unnecessary interventions and giving the patient the time needed to understand their clinical situation and play an active role in decision-making.

Treatment options and clinical follow-up

Treatment is tailored to the individual and implemented progressively, depending on the mechanisms involved in each case. It may include strategies aimed at modulating the gut microbiota, regulating motility and the neuromuscular function of the digestive and abdominal walls, as well as other specific medical measures where appropriately indicated.

The therapeutic approach is aimed at restoring functional digestive balance, with ongoing clinical monitoring and periodic reassessment of the response to treatment

An expert approach with ongoing support

The unit is led by a specialist with extensive experience in functional digestive disorders, the microbiota and the gut-brain axis, and is able to work in coordination with other specialists at the hospital when clinical complexity so requires.

The care model is based on an active clinical humanism, with support provided throughout all stages of the diagnostic and therapeutic process. Care is delivered in a trusting environment, with sufficient time set aside to explain findings, address concerns and facilitate informed decision-making, tailored to each individual and each clinical situation.