functional gastric disease

Functional gastrointestinal (GI) disorders refer to a group of conditions that affect the digestive system, but do not have a clear structural or biochemical cause. These disorders are characterized by chronic abdominal complaints and can be caused by various factors such as:

• Altered gut motility: The digestive tract does not move properly, leading to symptoms like constipation or diarrhea [3].
• Visceral hypersensitivity: The nerves in the digestive tract become overactive, causing pain and discomfort [5].
• Altered mucosal and immune function: The lining of the digestive tract and the immune system are affected, leading to inflammation and other symptoms [5].
• Altered gut microbiota: The balance of good and bad bacteria in the digestive tract is disrupted, contributing to symptoms like bloating and gas [5].

Some common examples of functional GI disorders include:

• Irritable bowel syndrome (IBS): Characterized by abdominal pain or discomfort associated with altered bowel habits [6].
• Functional dyspepsia: A condition that affects the upper part of the digestive tract, causing symptoms like bloating and nausea [13].
• Constipation: A condition where bowel movements are infrequent or difficult to pass [6].

These disorders can significantly impact a person's quality of life, with symptoms affecting daily activities and overall well-being. Diagnosis is often based on symptom-based criteria, such as the Rome IV criteria, which define functional dyspepsia as the presence of epigastric pain syndrome, postprandial distress syndrome (PDS), or a combination of both [13].

Functional GI disorders are estimated to affect up to 40% of people at any given time and frequently overlap with other conditions. They can be challenging to diagnose and treat, but various therapies and lifestyle modifications can help manage symptoms and improve quality of life.

References:

[3] - Functional gastrointestinal (GI) disorders may occur as the result of the digestive tract not operating properly. [5] - Functional gastrointestinal disorders (FGIDs), the most common diagnoses in gastroenterology, are recognized by morphologic and physiological abnormalities that often occur in combination including motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system processing. Research on these gut–brain interaction ... [6] - What are functional gastrointestinal diseases? Functional diseases are those in which the GI tract looks normal when examined, but doesn't move properly. They are the most common problems affecting the GI tract (including your colon and rectum). Constipation, irritable bowel syndrome (IBS), nausea, gas, bloating and diarrhea are common examples. [13] - Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders, affecting over 20% of the population. The condition has 3 subtypes—epigastric pain syndrome, postprandial distress syndrome (PDS), and a combination of both—each thought to result from different mechanisms. Diagnosis is based on the Rome IV criteria, which define functional dyspepsia as the presence of ...

Functional gastrointestinal (GI) diseases, also known as functional GI disorders, are characterized by chronic symptoms such as pain, bloating, and changes in bowel habits, despite the absence of any structural abnormality or disease.

Common signs and symptoms:

• Abdominal pain or cramping
• Bloating and gas
• Changes to stool (diarrhea or constipation)
• Vomiting
• Weakness or fatigue
• Unexplained weight loss
• Rectal bleeding or bloody stools

These symptoms can vary in severity and frequency, but they are often persistent and recurring. In some cases, the symptoms may resemble those of a peptic ulcer disease, but when tested, only about 1/3 of people will have a stomach ulcer - the other 2/3 will have functional dyspepsia.

Other symptoms:

• Heartburn
• Indigestion/dyspepsia
• Bloating and constipation
• Aerophagia (excessive belching)
• Chronic abdominal pain

It's essential to note that these symptoms can be similar to those of other conditions, such as irritable bowel syndrome (IBS), which is a functional condition where the intestinal muscles contract abnormally. However, IBS is an ongoing condition that needs long-term management.

References:

• [3] Functional gastrointestinal and motility disorders are the most common GI disorders in the general population.
• [6] Change in bowel habits; Unexplained weight loss; Rectal bleeding or bloody stools; Weakness or fatigue; Abdominal pain or cramping; Incomplete bowel movements.
• [7] signs and symptoms of functional GI disorders relate to abnormal intestinal motility, abnormal intestinal perception, and/or abnormal brain-gut communication.
• [10] Functional GI diseases are characterized by chronic (persistent or recurring) symptoms like pain and bloating that arise due to the dysfunction of the digestive tract.

Diagnostic Tests for Functional Gastric Disease

Functional gastric diseases, also known as functional gastrointestinal disorders (FGIDs), are conditions that affect the functioning of the digestive system without any visible structural damage. Diagnosing these conditions can be challenging due to overlapping symptoms with other diseases.

Imaging Tests

Several imaging tests may be used to diagnose functional gastric diseases:

• Colorectal transit study: This test shows how well food moves through the colon, which can help identify issues related to constipation or diarrhea.
• CT scan: A CT scan can help rule out other conditions that may cause similar symptoms.
• Defecography: This test involves taking X-rays while you defecate to assess the movement of stool through the rectum and anus.
• Lower GI (gastrointestinal) series: This test uses a contrast agent and X-rays to visualize the lower digestive tract.

Blood Tests

Blood tests may be used to rule out other conditions that can cause similar symptoms, such as:

• Tests for Helicobacter pylori (H. pylori): H. pylori is a bacterium that can cause stomach problems.
• Other bloodwork: Additional blood tests may be ordered to evaluate the presence of other diseases.

Additional Diagnostic Tests

Depending on the symptoms and medical history, additional diagnostic tests such as:

• Colonoscopy
• Breath testing
• Endoscopy may be recommended to rule out other conditions or structural problems.

Ruling Out Other Conditions

It's essential to note that functional gastric diseases can often mimic symptoms of other conditions. Therefore, a thorough evaluation and diagnostic testing are necessary to rule out other diseases before making a diagnosis.

References:

[3] Depending on symptoms, evaluation might include diagnostic testing such as bloodwork, colonoscopy, breath testing, and close and frequent follow-up. [7] Dec 22, 2022 — It's important to rule out inflammatory bowel disease (IBD) before diagnosing a functional GI disorder. Colonoscopies are the gold standard for ... [13] Diagnosis of Functional Gastrointestinal Disorders . Although the Rome criteria allow the diagnosis of FGDs to be symptom-based, your healthcare provider may still want to run some standard diagnostic tests to rule out other diseases or to look for structural problems that are resulting in your symptoms. [14] The diagnostic yield of upper endoscopy increases with age . In the absence of warning signs, upper endoscopy in younger patients is unlikely to find a worrisome cause. Additional evaluation and management — Most patients with a normal upper endoscopy and routine laboratory tests have functional dyspepsia. However, additional evaluation may ...

Functional gastric disease, also known as functional dyspepsia, is a condition characterized by recurring symptoms such as upper abdominal pain or discomfort, bloating, and changes in bowel habits. While there are no specific medications that can cure functional gastric disease, various pharmacological treatments can help alleviate its symptoms.

Antispasmodics and Motility Agents

According to search result [2], antispasmodics, neuromodulators, motility agents, and antidepressants have been found to be effective in treating functional dyspepsia. These medications work by relaxing the muscles in the stomach and intestines, improving digestion, and reducing symptoms such as bloating and abdominal pain.

Prokinetics

Search result [13] mentions that ongoing drug development focuses on gastric motility with prokinetics (dopamine-2 antagonists and 5-HT4 agonists) and fundus relaxant therapies (acotiamide, azapirones). Prokinetics are medications that stimulate the movement of food through the digestive system, which can help alleviate symptoms of functional dyspepsia.

Antidepressants

Search result [6] suggests that people with moderate to severe IBS may benefit from antidepressant medication management alone or in combination with other treatments. While not specifically mentioned for functional gastric disease, antidepressants have been found to be effective in treating certain gastrointestinal disorders.

Other Treatments

Search results [5], [7], and [8] mention various other treatments that can help manage symptoms of functional gastric disease, including lifestyle modification, dietary changes, and supplementation with soluble fiber preparations such as psyllium.

In summary, while there is no specific "drug treatment" for functional gastric disease, various pharmacological treatments can help alleviate its symptoms. These include antispasmodics, motility agents, prokinetics, antidepressants, and other medications that target the underlying mechanisms of the condition.

References:

[2] Pharmacological treatment with antispasmodics, neuromodulators, motility agents and antidepressants is effective. [6] People with moderate to severe. IBS may benefit from antidepressant medication management alone or in combination other treatments. [7] The management of FGIDs typically involves a multimodal approach, including lifestyle modification, dietary changes, and pharmacotherapy. [8] Supplementation with soluble fiber preparations such as psyllium can help manage symptoms of functional gastric disease. [13] Ongoing drug development focuses on gastric motility with prokinetics (dopamine-2 antagonists and 5-HT4 agonists) and fundus relaxant therapies (acotiamide, azapirones).

Differential Diagnoses for Functional Gastric Disease

Functional gastric diseases, also known as functional gastrointestinal disorders (FGIDs), are conditions that affect the functioning of the digestive system without any visible structural abnormalities. When diagnosing these conditions, it's essential to consider various differential diagnoses to rule out other potential causes of symptoms.

Common Differential Diagnoses:

• Gastro-oesophageal reflux disease (GERD): A condition characterized by the reflux of stomach contents into the esophagus, causing heartburn and regurgitation. GERD is a common cause of "dyspeptic symptoms" and should be considered in the differential diagnosis of functional gastric diseases.
• Abdominal angina: A condition characterized by chest pain or discomfort that mimics cardiac ischemia but is caused by reduced blood flow to the stomach.
• Acute cholecystitis and biliary colic: Inflammation of the gallbladder or bile ducts, which can cause abdominal pain and tenderness.
• Acute intermittent porphyria: A rare genetic disorder that affects the production of heme, leading to symptoms such as abdominal pain, nausea, and vomiting.
• Acute mesenteric ischemia: A condition characterized by sudden onset of abdominal pain due to reduced blood flow to the intestines.

Other Considerations:

• Functional dyspepsia: A condition characterized by persistent or recurrent upper abdominal discomfort or pain without any evidence of structural disease. Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders, affecting over 20% of the population.
• Irritable bowel syndrome (IBS): A condition characterized by recurring abdominal pain and changes in bowel habits, such as diarrhea or constipation.

Key Points to Consider:

• A diagnosis of a functional gastric disease does not exclude the possibility of a concurrent disease. Vice versa, a structural abnormality may coexist with a functional disorder.
• The presence of symptoms such as postprandial fullness, early satiation, epigastric pain, or burning should be evaluated in the context of potential differential diagnoses.

References:

• [4] Functional GI and motility disorders generally cannot be diagnosed in a traditional way. No inflammatory, infectious, or structural abnormality can be seen.
• [14] Gastro-oesophageal reflux disease (GERD) is a potential cause of “dyspeptic symptoms” that is highly prevalent in the community.
• [8] Differential Diagnoses · Abdominal Angina · Acute Cholecystitis and Biliary Colic · Acute Intermittent Porphyria · Acute Mesenteric Ischemia.