Functional Gastrointestinal Disorders 

Functional gastrointestinal disorders such as irritable bowel syndrome (IBS), functional diarrhoea or constipation and functional dyspepsia are the most common conditions seen in gastroenterology practice.

The diagnosis can usually be established with a thorough history and careful physical examination. Expensive endoscopic and laboratory tests are infrequently needed. A good dietary history may reveal food triggers.

Non-Ulcer Dyspepsia

Symptoms of dyspepsia include upper abdominal pain or discomfort and frequently include symptoms of burning, pressure, or fullness often, but not necessarily, related to meals.

Other common symptoms include early feeling of fullness (satiety), nausea, belching, and bloating.

While dyspeptic symptoms may develop due to diseases such as peptic ulcer or gastritis, the vast majority of people who see doctors for dyspeptic symptoms are ultimately diagnosed as having functional dyspepsia.

Some studies suggest that FD is a chronic condition for many people, with approximately 50% of patients still experiencing symptoms over a 5-year follow-up period.

The causes of functional dyspepsia are largely unknown and likely multiple. Some evidence exists to implicate a genetic predisposition. In approximately 40% of patients with dyspepsia, the stomach does not relax normally in response to a meal.

This is known as “impaired accommodation” and may be associated with symptoms of fullness and pressure in some patients. Impaired stomach contractions and abnormal stomach emptying may also be seen in a similar percentage of patients.

Treatment options for functional dyspepsia generally include one or a combination of:
• Diet
• Eradication of H. pylori
• Acid-lowering medications
• Prokinetic and antiemetic agents
• Centrally acting drugs