Functional Digestive Disorders
The most common causes of digestive symptoms
Digestive problems and disorders are divided into two general diagnostic categories, pathologic and functional. Pathologic simply means distinct disorders that can be seen such as with endoscopy, colonoscopy, biopsy or other similar means. Examples may include gastric ulcers, ulcerative colitis, gallstones and others.
Functional digestive disorders are symptomatic disorders where there are no anatomical, structural or organic abnormality that explains the symptoms. Rather, they are disorders of function where things do not function properly resulting in symptoms. Irritable bowel syndrome, or IBS, is the prototypic functional disorder. Extensive testing such as colonoscopy and endoscopy do not reveal any abnormalities yet symptoms are present.
The importance of functional digestive disorders comes from the fact that they are 3 to 4 times more common than pathological disorders.
The vast majority of endoscopic exams looking for gastric and intestinal ulcers and other pathologies are normal resulting in a functional diagnosis such as dyspepsia or irritable bowel syndrome. Treatment is often directed at symptoms and not at a specific cause of the problem. While it is important to rule out important pathologies of the digestive tract, it is equally important to fully explore functional causes which are the origin of symptoms in the majority of cases.
The factors thought to be involved in functional digestive disorders include inflammation, dysmotility (things don’t move properly), and altered tissue sensitivity. The real question to understand and treat functional digestive disorders is what are the factors causing the altered inflammatory signaling, dysmotility or abnormal tissue sensitivity. For example, if inflammation is present, what is causing the inflammation? Triggers are typically food sensitivities, imbalance in the gut microbiome, a pro-inflammatory diet and others. Discovering and treating these factors will lead to true resolution of functional digestive disorders.
In the sections on each specific type of functional digestive disorder the features, common underlying causes and treatment solutions are discussed for each.