What are Functional Gastrointestinal Disorders (FGIDs): Causes, Symptoms & Risk Factors

By Dr. Vibhu Mittal in Gastroenterology, Hepatology & Endoscopy

Nov 05 , 2024 | 2 min read

Functional gastrointestinal disorders (FGIDs) are a group of conditions characterised by chronic symptoms affecting the gastrointestinal (GI) tract without identifiable structural abnormalities. These disorders are common and can significantly impact patients' quality of life. This article provides an overview of FGIDs, their causes, symptoms, diagnosis, and management strategies.

What are Functional Gastrointestinal Disorders?

FGIDs include a variety of conditions where symptoms arise from abnormal functioning of the GI tract rather than structural or biochemical abnormalities. Common FGIDs include:

Irritable Bowel Syndrome (IBS): Characterised by abdominal pain, bloating, and altered bowel habits (diarrhoea, constipation, or both).
Functional Dyspepsia: Symptoms include persistent or recurrent pain in the upper abdomen, often associated with bloating and early satiety.
Functional Esophageal Disorders: Conditions like functional heartburn and eosinophilic esophagitis that cause symptoms without obvious organic disease.
Chronic Functional Abdominal Pain: Persistent abdominal pain not attributable to any identifiable cause.
Functional Bowel Disorders: Including constipation and diarrhoea not explained by structural or biochemical abnormalities.

Causes and Risk Factors

The exact cause of FGIDs is not fully understood, but several factors may contribute:

Gut-Brain Interaction: Dysregulation in the communication between the gut and the brain can lead to altered gut motility and sensitivity.
Psychological Factors: Anxiety, depression, and stress can exacerbate symptoms and may be both a cause and consequence of FGIDs.
Dietary Factors: Certain foods may trigger symptoms, and dietary patterns can influence gut health.
Infections and Inflammation: Gastrointestinal infections or inflammation can lead to the development of FGIDs in some cases.

Symptoms of Functional Gastrointestinal Disorders

Symptoms of FGIDs can vary widely and may include:

Abdominal pain or discomfort
Bloating and distension
Changes in bowel habits (diarrhoea, constipation, or alternating patterns)
Nausea or early satiety
Difficulty swallowing (in functional esophageal disorders)

Diagnosis of Functional Gastrointestinal Disorders (FGIDs)

Diagnosing FGIDs typically involves:

Clinical History: A detailed history of symptoms, including their onset, duration, and impact on daily life.
Symptom-Based Criteria: The Rome IV criteria are commonly used to classify and diagnose FGIDs based on symptom patterns.
Exclusion of Organic Causes: Laboratory tests, imaging studies, and endoscopic evaluations may be conducted to rule out other gastrointestinal diseases.

Management Strategies

Managing FGIDs often requires a multifaceted approach:

Dietary Modifications: Identifying and avoiding trigger foods, implementing dietary changes (e.g., a low FODMAP diet for IBS), and ensuring adequate fibre intake.
Medications: Depending on symptoms, treatments may include antispasmodics, laxatives, anti-diarrhoeal agents, or medications targeting gut motility. Psychological therapies (like antidepressants) may also be beneficial for some patients.
Psychological Interventions: Cognitive-behavioural therapy (CBT), mindfulness, and stress management techniques can help address the psychological aspects of FGIDs.
Lifestyle Changes: Regular physical activity, adequate hydration, and maintaining a consistent eating schedule can support digestive health.
Patient Education and Support: Providing information about the nature of FGIDs can empower patients and reduce anxiety related to symptoms.

Conclusion

Functional gastrointestinal disorders are common and can significantly impact patients' lives. Understanding these conditions, their causes, and management strategies is essential for effective treatment. A holistic approach that includes dietary changes, psychological support, and symptom management can help improve patients' quality of life. Ongoing research continues to shed light on the underlying mechanisms of FGIDs, paving the way for more effective therapies and individualised care