Functional gastrointestinal disorders (FGIDs) are prevalent in adults, adolescents, and children. They are also known as disorders of gut-brain interaction.
FGIDs cause sensitivity and a host of symptoms in the gastrointestinal (GI) tract, but ones that are the result of atypical functionality, not a disease or infection. Your doctor can diagnose a FGID and set up a management plan that works for you.
A 2021 study found that around 40 percent of people live with FGIDs throughout the world, though they can be more common in women. FGIDs can occur anywhere along the GI tract, including the esophagus, stomach, and intestines.
According to a 2021 review, there are 33 adult conditions and 20 pediatric conditions that can be diagnosed as FGIDs. Some include:
- irritable bowel syndrome
- gastroesophageal reflux disease
- functional dyspepsia (indigestion)
- functional nausea and vomiting
- functional abdominal pain
- functional constipation
- functional diarrhea
- fecal incontinence
Some causes of FGIDs are environmental, like stress and smoking, and can be greatly affected by lifestyle changes. There are also many causes that you have no control over, such as:
- family history
- gut sensitivity
- GI movements that are too fast or slow
- immune system functioning
- central nervous system processing
- anxiety and depression
According to a 2017 report, physical symptoms can range depending on your exact condition. They can include:
- abdominal pain
- swallowing difficulties
Symptoms of FGIDs in infants and children
Children may have the symptoms listed above. But according to the American College of Gastroenterology, the most common FGID symptom in children is functional abdominal pain. That is, pain that is coming atypical function of the GI system, rather than an illness.
Many infants may have combined FGIDs in their first 6 months, according to a
- gas or bloating
The study concluded that combined FGIDs could affect an infant’s ability to gain weight and breastfeed. Combined FGIDs also affected their quality of life.
Talking with your doctor will help you identify your symptoms, reflect on how they affect your quality of life, and determine a custom treatment plan. FGIDs are more complex to diagnose than other conditions. Laboratory and imaging tests may not indicate anything specifically unusual about your GI tract even if you have symptoms.
A consultation with your doctor to diagnose a FGID may take some time. Your doctor will:
- interview you
- ask you about your symptoms, health history, and family health history
- perform a physical exam
Your doctor may order laboratory tests like blood, urine, and stool samples or imaging tests like X-rays or CT scans, but these may not be conclusive.
Some of the questions your doctor may ask at the appointment include:
- When did the symptoms start?
- What are your concerns?
- Do these symptoms prevent you from doing certain activities?
- What do you expect from treatment?
- Do you have concerns about what this condition might be?
Your doctor may also ask you about your lifestyle. This includes your diet, exercise habits, and sleep routine. Consider keeping a journal that notes your symptoms and other information related to the condition, especially your diet. This can provide invaluable data for your diagnosis, so be sure to bring the journal to your appointment.
A consultation with your doctor may result in a FGID diagnosis based on the Rome Criteria. The Rome Foundation is an organization that publishes criteria for FGIDs.
A 2021 review indicates that we don’t have the understanding of FGIDs it would take to cure them, however, they can be managed. The goal of treatment will be to reduce your symptoms and increase your quality of life.
Treatments vary from person to person. There are many types of FGIDs. You may respond differently to treatments than another person with your specific condition. Treatment options include lifestyle changes, mental well-being management, and medications.
You may want to seek treatment from a team of specialists instead of just a single doctor. Those who may be able to help manage your condition include:
- your general doctor
- a specialist
- mental health professionals like counselors, therapists, and psychologists
The University of North Carolina School of Medicine reports that 50 to 80 percent of people living with FGIDs do not seek the care of a doctor, but may treat the condition with over-the-counter medications. Without treatment, you may miss work, school, or other activities because of your symptoms.
Lifestyle change treatments
There are many aspects of your lifestyle to consider when treating FGIDs:
- Sleep. Quality sleep every night can reduce symptoms.
- Exercise. Exercising at least three to five times per week for 20 to 30 minutes can help your bowels, lower stress, and improve your sleep patterns.
- Caffeine. This stimulant can cause diarrhea and disrupt sleep.
- Alcohol. This is a depressant that can cause reflux and indigestion.
- Diet. It is important to understand how your diet affects your symptoms. Keeping a food diary, meeting with a dietitian or nutritionist, adhering to a specific diet, restricting or adding certain foods, supplementing with fiber, and taking a probiotic might all be options to help ease symptoms.
Mental well-being treatments
There are several therapies that may assist with reducing symptoms, including:
- Cognitive behavioral therapy: can help you recognize and understand unhelpful thought and behavior patterns
- hypnotherapy: can help reduce anxiety around symptoms and calm your stomach
- psychotherapy: also called “talk therapy”, can help you give insight and perspective
- mindfulness: can help you stay present in the moment, rather than dwelling on future symptoms
Relaxation methods and biofeedback may also be useful for treating mental health.
You may need to take anxiety or depression medications to treat any diagnosed mental health conditions.
Your doctor will recommend certain medications based on your symptoms and diagnosis. These may be available over the counter or require a prescription. Some of the first- and second-line medications your doctor may recommend for FGIDs are:
- antispasmodics and neuromodulators (such as antidepressants), for pain management
- loperamide and ondansetron, for diarrhea
- osmotic laxatives and prucalopride, for constipation
- proton pump inhibitors, H. pylori eradication therapy, H2 blockers, and prokinetics, for indigestion
Follow the instructions on the over-the-medications or the advice of your doctor. Contact them if your symptoms don’t improve or get worse.
FGIDs are common and can interfere with your everyday activities. They affect a large amount of the population and include a variety of conditions, from irritable bowel syndrome and functional diarrhea to constipation and vomiting.
Your doctor can diagnose your condition based on your symptoms and other factors. Treatment plans include lifestyle changes, mental health management, and medications.