Many people suffer from gastrointestinal disorders that seem to be difficult to diagnose on the basis of physical and laboratory examinations. Approximately one in four people suffer from functional gastrointestinal disorders (FGIDs), which make up about 40% of all gastrointestinal problems seen by doctors in the US.
What are Functional Gastrointestinal Disorders?
FGIDs are common health problems characterized by persistent and recurring gastrointestinal symptoms, which occur due to abnormal functioning of the digestive tract. However, these are not caused by infection, tumors or biochemical abnormality. In spite of the marked complaints from an affected individual, routine laboratory tests such as blood tests, imaging exams and endoscopic exams do not show any structural or chemical abnormalities.
Functional disorder can affect any part of the digestive tract, and there has been more than twenty conditions identified. These include conditions such as functional diarrhea, functional constipation, functional abdominal pain, functional abdominal bloating, etc, for which no specific cause or abnormality has been found. Irritable bowel syndrome is also among this type of disorders, and is in fact, the most common condition that causes disability and absence from work or school.
Aside from being persistent, FGIDs have some common features. They are usually characterized by a disturbance in motility, or the muscular contraction of any part of the digestive system. This results in either painful spasms or disorganized, slow contractions. These lead, for example, to either chronic diarrhea or chronic constipation. Another feature of FGIDs is the increased sensitivity of the digestive tract to stimulus, such that eating and digesting a meal, for example, can lead to pain. Finally, a person with a functional gut disorder has brain-gut dysfunction, which is a loss of harmony in the communication between the brain and the digestive system.
With not much laboratory or physical signs to work with, doctors usually make the diagnosis of a functional disorder from the patient's medical history and clinical presentation. Doctors use some criteria for diagnosing FGIDs based on symptoms.
It is also important to remember that in as much as FGIDs are not organic disorders, they are not psychiatric disorders, either. However, these conditions may be exacerbated by stress and anxiety, and one's symptoms can also lead to stress and reduced quality of life.
There is no specific treatment for FGIDs, but doctors often prescribe drugs and remedies to relieve a patient's symptoms. These include anti-motility drugs to reduce gastrointestinal spasms, such as Bentyl and Imodium, and pro-motility drugs to improve gastrointestinal contraction, such as Amitiza and Zelnorm. Sometimes, antidepressant drugs are also prescribed to reduce pain and depression associated with the disorder.
Patients may also be advised to eat high-fiber foods or to eliminate certain foods from the diet, such those that produce gas. Eating smaller meals, avoiding dairy products and drinking plenty of fluids may also help improve symptoms. Exercising regularly and receiving counseling support may also help people deal with their symptoms.
Research shows that as much as 50 to 80% of people with FGIDs do not go to their doctors for consultation and treatment. Many use over-the-counter drugs to manage their symptoms, resulting in increased absenteeism and reduced work productivity.
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