,i #aafth ,,congress #ast ,session ,h4 ,r4 #ccif ,,in ,,the ,,house ,,of ,,representatives ,june #bj1 #bjai,mr4 ,sensenbrenner 7for himself and ,ms4 ,moore7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to expand the research activities of the ,national ,institutes of ,health with respect to functional gastrointestinal and motility disorders1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,functional ,gastrointestinal and ,motility ,disorders ,research ,enhancement ,act of #bjai4 #b4 ,findings ,congress finds the following3 7#a7 ,functional gastrointestinal and motility disorders 7,f,g,i,m,ds7 are chronic conditions associated with increased sensitivity of the ,,gi tract1 abnormal motor functioning1 and brain-gut dysfunction4 7#b7 ,f,g,i,m,ds are characterized by chronic or recurring symptoms in the ,,gi tract including pain or discomfort1 nausea1 vomiting1 diarrhea1 constipation1 incontinence1 problems in the passage of food or feces1 or a combination of these symptoms4 7#c7 ,f,g,i,m,ds include both common and rare conditions1 such as functional dysphagia1 gastroesophageal reflux disease1 dyspepsia1 cyclic vomiting syndrome1 gallbladder and bile duct dysfunction1 gastroparesis1 irritable bowel syndrome 7,,ibs71 ,hirschsprung's disease1 chronic intestinal pseudo-obstruction1 bowel incontinence1 opioid induced ,,gi hyperalgesia1 abdomino-phrenic dyssynergia 7,,apd71 and many others1 which affect the esophagus1 stomach1 gallbladder1 small and large intestine1 and anorectal areas of the body4 7#d7 ,the severity of ,f,g,i,m,ds ranges from mildly uncomfortable to debilitating and in some cases can be life-threatening4 7#e7 ,effective treatments for the multiple symptoms of ,f,g,i,m,ds are lacking1 and while sufferers frequently use a variety of medications and therapies for symptoms1 few patients report satisfaction with available treatments4 7#f7 ,physicians are not sufficiently educated on the proper diagnosis and up-to-date treatments for ,f,g,i,m,ds4 ,this leads to excess health care costs due to unneeded diagnostic procedures and errors in treatments4 7#g7 ,frequently there is a need for a multidisciplinary care approach to patients with ,f,g,i,m,ds1 including access to nutritional and mental health support to improve pain management and facilitate patient and parent understanding of the brain-gut axis and overall patient functioning4 7#h7 ,patients with ,f,g,i,m,ds frequently suffer for years before receiving an accurate diagnosis1 exposing them to unnecessary and costly tests and procedures including surgeries1 as well as needless suffering and expense4 7#i7 ,the economic impact of ,f,g,i,m,ds is high4 ,the annual cost in the ,united ,states for ,,ibs alone is estimated to be between #a4g billion and #aj billion in direct medical costs 7excluding prescription and over-the-counter medications7 and #bj billion in indirect medical costs4 7#aj7 ,f,g,i,m,ds frequently take a toll on the workplace1 as reflected in work absenteeism1 lost productivity1 and lost opportunities for the individual and society4 7#aa7 ,gastrointestinal symptoms consistent with functional gastrointestinal disorders1 such as ,,ibs and functional dyspepsia1 are recognized as a serious and disabling issue for military veterans1 particularly those who have been deployed in war zones and experience posttraumatic stress disorder4 7#ab7 ,f,g,i,m,ds affect individuals of all ages including children1 and pediatric ,f,g,i,m,ds can be particularly serious1 leading to a lifetime of painful symptoms and medical expenses associated with management of chronic illness or death1 as well as missed school days and homebound instruction4 7#ac7 ,there is inadequate public education and misunderstanding of ,f,g,i,m,ds leading to stigma placed upon individuals so afflicted4 7#ad7 ,the ,national ,institutes of ,health's ,national ,commission on ,digestive ,diseases identified comprehensive research goals related to ,f,g,i,m,ds in its ,april #bjji report to ,congress and the ,american public entitled ,opportunities and ,challenges in ,digestive ,diseases ,research3 ,recommendations of the ,national ,commission on ,digestive ,diseases4 #c4 ,functional gastrointestinal and motility disorders research enhancement ,part ,b of the title ,,iv of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhd et seq47 is amended by adding at the end the following3 #dji,k4 ,functional gastrointestinal and motility disorders ,the ,director of ,,nih may expand1 intensify1 and coordinate the activities of the ,national ,institutes of ,health with respect to functional gastrointestinal and motility disorders 7in this section referred to as ,f,g,i,m,ds7 by-- 7#a7 expanding basic and clinical research into ,f,g,i,m,ds by implementing the research recommendations of the ,national ,commission on ,digestive ,diseases relating to ,f,g,i,m,ds2 7#b7 providing support for the establishment of up to #e centers of excellence on ,f,g,i,m,ds at leading academic medical centers throughout the country to carry out innovative basic1 translational1 and clinical research focused on ,f,g,i,m,ds in both pediatric and adult patients2 7#c7 supporting innovative approaches to educating health care providers and patients regarding strategies that improve patient-provider relationships and care and foster research to determine the effects of these approaches in improving patient satisfaction1 improved clinical outcomes1 efficient utilization of health care services1 and reduced health care costs2 7#d7 exploring collaborative research opportunities among the ,national ,institute of ,diabetes and ,digestive and ,kidney ,diseases1 the ,office of ,research on ,women's ,health1 the ,office of ,rare ,diseases1 the ,national ,institute of ,mental ,health1 and other institutes and centers of the ,national ,institutes of ,health2 7#e7 directing the ,national ,institute of ,diabetes and ,digestive and ,kidney ,diseases to provide the necessary funding for continued expansion and advancement of the ,f,g,i,m,ds research portfolio through intramural and extramural research2 7#f7 directing the ,national ,institute of ,diabetes and ,digestive and ,kidney ,diseases and the ,eunice ,kennedy ,shriver ,national ,institute of ,child ,health and ,human ,development to expand research into ,f,g,i,m,ds that impact children1 such as ,hirschsprung's disease and cyclic vomiting syndrome1 and maternal health1 such as fecal incontinence2 and 7#g7 exploring opportunities to partner with the ,department of ,defense and the ,department of ,veterans ,affairs to increase research and improve patient care regarding ,f,g,i,m,ds that commonly impact veterans and active duty military personnel1 such as ,,ibs and dyspepsia4 4 #d4 ,promoting public awareness of functional gastrointestinal and motility disorders ,part ,b of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdc et seq47 is amended by adding at the end the following3 #cbj;,b4 ,public awareness of functional gastrointestinal and motility disorders ,the ,secretary may engage in public awareness and education activities to increase understanding and recognition of functional gastrointestinal and motility disorders 7in this section referred to as ,f,g,i,m,ds74 ,such activities may include the distribution of print1 film1 and web-based materials targeting health care providers and the public and prepared and disseminated in conjunction with patient organizations that treat ,f,g,i,m,ds4 ,the information expressed through such activities should emphasize-- 7#a7 basic information on ,f,g,i,m,ds1 their symptoms1 prevalence1 and frequently co-occurring conditions2 and 7#b7 the importance of early diagnosis1 and prompt and accurate treatment of ,f,g,i,m,ds1 including access to nutritional and mental health support4 4 #e4 ,sense of ,congress of the development and oversight of innovative treatment options for functional gastrointestinal and motility disorders ,it is the sense of ,congress that1 considering the current lack of effective treatment options for the global symptoms of functional gastrointestinal and motility disorders 7in this section referred to as ,f,g,i,m,ds7 and the inherent challenges of developing and bringing such treatments to market1 the ,commissioner of ,food and ,drugs should continue and accelerate important efforts to improve the development and oversight of treatment options for ,f,g,i,m,ds by-- 7#a7 enhancing the commitment to emerging efforts like the ,patient ,reported ,outcomes ,consortium to expedite medical device and drug development1 the study of appropriate balances between risk and patient benefit1 and identification of proper endpoints for conditions without clear1 biological indicators2 7#b7 enhancing the commitment to broad efforts like the ,critical ,path ,initiative focused on ensuring that scientific breakthroughs are quickly translated into safe and beneficial treatment options for both pediatric and adult patients2 and 7#c7 continuing collaboration with patient and provider organizations that treat ,f,g,i,m,ds so that the patient perspective is considered when determining the need for innovative treatments4