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Understanding and Managing Invisible GI Disorders

Many people suffer in silence from symptoms that others dismiss simply because they aren't visible. A typical scenario unfolds when someone says, "I don't feel great—my stomach hurts, and I'm uncomfortable," only to hear, "But you look fine! It's probably nothing serious." This reaction is common, even from healthcare providers, especially when exams and tests fail to reveal a clear cause. Often classified as functional disorders, these conditions disrupt organ function without showing visible damage.

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 Changing Paradigms in Functional Gastrointestinal Disorders

Because there is no obvious structural explanation, it is presumed that a disturbance of function is at work. For example, a sensory disorder, a motor disorder, or perhaps a disorder of central processing of gut-brain signaling may be present. However, in my view, this is an old, outmoded paradigm. Researchers have been intensely searching to find possible structural changes in patients with FGIDs. Recent studies of intestinal tissue have demonstrated that, at least in a subset of patients, subtle gut pathology is present with immune activation and is likely important in the etiopathogenesis of the disease. This is an exciting time because new answers are finally emerging

 Recognizing and treating disorders of gut-brain interaction

While some of these conditions can be devastating, they are usually easy to diagnose on standard testing. But there are other illnesses that can impact the GI tract that do not have a clear laboratory test or finding on endoscopy to identify them. One such class of these is called disorders of gut-brain interaction, or DGBIs. Some people (including doctors) may be familiar with the older term used to describe these conditions — functional GI diseases — but it is no longer used.DGBIs can include irritable bowel syndrome, reflux hypersensitivity, or functional dyspepsia. They are called disorders of gut-brain interaction because it is believed the most critical abnormality is impaired communication between the gut and the brain via the nervous system in both directions (from gut to brain and brain to gut).

Articles of Interest

When Form Doesn’t Function: Functional Gastrointestinal Disorders

Each organ of the digestive system is formed to contribute to a person's overall function and digestive health. When one or more organ(s) appear(s) to be normal in form but is not functioning as it was intended, then acute and chronic symptoms can develop into what is known as functional gastrointestinal disorder (FGID). FGID can lead to continuous and/or recurring abdominal pain and other bothersome symptoms that have a negative impact on the quality of life for those who are affected.

A Journey through GI Disease: Functional Disorders

There are many types of functional GI disorders. In this article, we’ll look at two of the most common: gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS).

Are My Stomach Problems Really All in My Head?

Scientists often debate whether irritable bowel syndrome is a mental or physical issue. That’s not much help for those who suffer from it.

Common Functional Gastroenterological Disorders Associated With Abdominal Pain

Although abdominal pain is a symptom of several structural gastrointestinal disorders (eg, peptic ulcer disease), this comprehensive review will focus on the 4 most common nonstructural, or functional, disorders associated with abdominal pain: functional dyspepsia, constipation-predominant and diarrhea-predominant irritable bowel syndrome, and functional abdominal pain syndrome. Together, these conditions affect approximately 1 in 4 people in the United States.

Functional gastrointestinal disorders

In very small children, FGDs represent the most common gastrointestinal reason for a doctor’s visit. This includes baby colic with regurgitation and constipation problems, IBS, and other less well characterized functional problems. Stomach pain, bloating, diarrhea, and constipation are commonly associated with FGDs and can have major consequences on a child’s daily life. Stress and anxiety can also favor or prolong certain symptoms, particularly pain.

Functional Gastrointestinal Disorders in Pediatric and Adolescent Patients

Functional gastrointestinal disorders are common in children and adolescents with complaints of abdominal pain. Our brains and our GI tracts are closely connected (the “mind-body connection”). Functional GI conditions are due to a combination of extra sensitivity of the GI tract, with changes in the motility or movement of the digestive system. Our stomachs and intestines are moving food all the time, and some people feel this more intensely than other people.

Functional gastrointestinal disorders: advances in understanding and management

These conditions affect up to 40% of people at any one point in time, and two-thirds of these people will have chronic, fluctuating symptoms. The pathophysiology of functional gastrointestinal disorders is complex, but involves bidirectional dysregulation of gut-brain interaction (via the gut-brain axis), as well as microbial dysbiosis within the gut, altered mucosal immune function, visceral hypersensitivity, and abnormal gastrointestinal motility. Hence, nomenclature refers to the conditions as disorders of gut-brain interaction.

Functional gastrointestinal disorders: psychological, social, and somatic features

Psychological, social, and extraintestinal (somatic) disturbances are prominent features of functional gastrointestinal disorders (FGID); little attention, however, has been given to differences in the nature of these disturbances in the various FGID subgroups.

Functional gastrointestinal disorders: unraveling the complexities of diagnosis and management

These disorders share common features, such as chronic or recurrent symptoms and the absence of structural abnormalities. The symptoms can vary widely among individuals, but often include abdominal pain, bloating, altered bowel habits, and discomfort. The exact cause of FGIDs remains unclear, but various factors such as altered gut motility, visceral hypersensitivity, gut-brain axis dysfunction, and psychosocial factors are believed to contribute to their development.

Functional GI Disorders

Functional GI disorders are disorders of gut–brain interaction. It is a group of disorders classified by GI symptoms related to any combination of the following: motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system (CNS) processing.[3]

How Doctors Help Children Tame the Beast in the Belly

An estimated 10 to 20 percent of all school-age children suffer severe recurrent abdominal pain. But many children and adolescents go for 13 to 18 months before being treated, and some are never treated at all. In some cases, untreated pain is so debilitating that they miss school, dance classes, sports activities and social events. They are at risk of falling behind academically, physically, socially and developmentally. Experts say that organic causes like ulcers, inflammation or intestinal blockages are to blame in only a small minority of children, 5 to 10 percent.

Management of functional gastrointestinal disorders

Functional gastrointestinal (GI) disorders (eg irritable bowel syndrome and functional dyspepsia) are very common conditions which are associated with very poor quality of life and high healthcare utilisation. They are caused by disorders of GI functioning, namely altered gut sensitivity, motility, microbiota, immune functioning and central nervous system processing. They cause chronic symptoms throughout the gut (eg pain, dyspepsia and altered bowel habit), all of which are made worse by maladaptive patient behaviours, stress and psychological comorbidity.

Patients with functional gastrointestinal disorders—importance of communication between physician and patient assessed in a cross-sectional cohort study

Functional gastrointestinal disorders are frequent diseases often associated with a pronounced burden reflected in a greatly reduced quality of life. Patients are seeking medical help but may be perceived as demanding and challenging. For successful diagnosis and treatment of these patients, a good doctor-patient communication is key.

Pediatric Functional Gastrointestinal Disorders

Functional gastrointestinal disorders (FGIDs) are conditions that include a combination of symptoms that are chronic or recurrent and are not explained entirely with current structural or biochemical investigations.

Stress and functional GI disorders

You may feel nauseated before giving a presentation or feel intestinal pain during times of stress. You're not imagining it. The gut and the brain influence each other. For example, stress (or depression or other psychological factors) can affect movement and contractions of the gastrointestinal tract, as well as sensations perceived to come from the gut. There is also emerging evidence that psychosocial factors may alter the types of bacteria that live in your gut, which can contribute to chronic inflammation.

The Differences Between Functional and Structural Gastrointestinal Disorders

Although functional gastrointestinal disorders can severely affect a person’s life, there is no underlying physical cause. Functional gastrointestinal disorders are characterized by their persistent and sometimes embarrassing symptoms. Irritable bowel syndrome and constipation are two common functional gastrointestinal disorders.

Understanding Functional GI Disorders: A Comprehensive Overview

Functional GI disorders are characterized by chronic and recurrent GI symptoms that interfere with daily life. The primary distinction of these disorders is that, despite the significant discomfort they cause, diagnostic tests do not reveal any structural abnormalities in the gastrointestinal tract. Instead, these disorders are believed to result from disruptions in how the GI tract functions.

What Is FGID? (Functional Gastrointestinal Disorder)

When it comes to understanding FGID and associated symptoms, it’s helpful to first consider what it is not.

Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study

The functional gastrointestinal disorders (FGIDs), or disorders of gut-brain interaction (DGBIs), are gastrointestinal (GI) disorders related to any combination of motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system processing. They result in significant global health care costs and impaired health-related quality of life (QOL).

Resources

International Foundation for Gastrointestinal Disorders

Our mission is to inform, assist, and support people affected by gastrointestinal (GI) disorders. IFFGD was founded in 1991 by one person struggling with the challenges imposed by a chronic GI disorder. Many others, from all walks of life, have joined with us.

Rome Foundation

Provides support for activities (like research and education) to assist in the diagnosis and treatment of disorders of gut-brain interaction (DGBIs).

Biocodex

Functional gastrointestinal disorders (FGDs), the most common intestinal afflictions, are a collection of chronic digestive symptoms that are not explained by any detectable anatomic anomaly.

Rome IV Criteria

Appendix A: Rome IV Diagnostic Criteria for FGIDs.

Pharmacy Times

Patients tend to manage FGIDs with OTC interventions for too long rather than seeking proper attention from a health care professional effectively to treat the disease. FGIDs encompass dysfunctions in motility, mucosal membranes, the central nervous system, normal gut flora, and the immune system, as well as organ hypersensitivity. In addition, the normal motility of the GI tract may be shallower or prolonged and spasms may or may not be present, which can create pain ranging from mild to extremely intense. The three most important features of FGIDs are brain-gut dysfunction, sensation, and peristalsis.

Verywell

In the past, FGDs were considered to be diagnoses of exclusion, meaning that they could only be diagnosed after organic (identifiable) disease was ruled out. However, back in 1988, a group of researchers and healthcare providers met to devise strict criteria for the diagnosis of the various FGDs. These criteria are now known as the Rome Criteria. The fourth revision came out in 2016.