Functional gastrointestinal disorders (FGIDs) denote a range of bowel-related conditions known for their recurring and persistent GI symptoms. With advancements in medical research, healthcare professionals can now identify these disorders with greater precision.

Understanding FGIDs

FGIDs stem from irregular activities within the gastrointestinal (GI) tract. They manifest through various GI symptoms that might arise from:

  • Motility Disorder: Irregular contractions in the gastrointestinal area.
  • Visceral Hypersensitivity: Heightened reaction to normal intestinal activities.
  • Altered Mucosal & Immune Function: Response shifts in the immune system at the intestinal mucosal barriers.
  • Microbiota Imbalance: Fluctuations in the intestinal microorganism populations affect overall health.
  • CNS Processing Deviations: Communication disruptions between the brain and the GI tract.

These abnormalities can potentially impact every part of the digestive system, encompassing areas like the esophagus, gastroduodenal, small and large intestines, gallbladder, biliary tract, and anorectum.

Manifestations of FGIDs

Patients with FGIDs often report symptoms like:

  • Unexplained abdominal discomfort.
  • Chest sensations akin to burning or discomfort.
  • Swallowing difficulties.
  • Recurring nausea, excessive gas, irregular bowel movements, including constipation and diarrhoea, or fluctuating between both.

Possible Origins

While pinpointing exact causes remains challenging, factors like stress, a low-fibre diet, irregular meal timing, insufficient physical activity, and a frantic lifestyle can play roles.

Diagnostic Approach

Accurately diagnosing FGIDs often necessitates collaboration between medical specialists from diverse disciplines and nursing professionals adept at digestive system intricacies. Overlapping symptoms, such as those seen in GERD patients, can complicate diagnosis.

Typically, medical experts refer to the Rome IV Diagnostic Criteria from the Rome Foundation. However, a holistic view of individual symptoms often determines the diagnostic procedure.

Diagnostic Techniques for Upper GI Disorders

  • Gastroscopy.
  • High-Resolution Esophageal Manometry and Impedance.
  • Esophageal pH Monitoring.
  • Long GI Study or GI Follow Through.
  • Gastric & Small Bowel Emptying Time.

Diagnostic Techniques for Lower GI Disorders

  • High-Resolution Anorectal Manometry and Biofeedback Training.
  • Colonoscopy.
  • Colonic Transit Test.
  • MRI Defecography.

Before The Examination

Specific preparations vary based on the diagnostic technique. Generally, patients should:

  • Share their medical history, current medications, and allergies.
  • Refrain from eating or drinking 4-8 hours before the test.
  • Possibly stop acid reflux medicines 3-5 days before the test. All guidelines are ultimately under the physician's guidance.

Potential Side Effects

While examinations are generally safe, there's a possibility of side effects. For instance, nosebleeds might occur in patients undergoing catheter insertions, especially if they're on blood thinners.