Functional Gastrointestinal Disorders: A Patient's Journey

Q: Functional Gastrointestinal Disorders: A Patient's Journey

Hello： If all tests show no obvious issues, it may be necessary to look for causes in your lifestyle, diet, and habits. <br>Avoid stimulating foods (such as tea, coffee, fried foods, and spicy foods), try not to be overly anxious or under significant stress, and develop a habit o

Gastrointestinal issues

Hello, doctor.
Last October, I experienced stomach pain, dizziness, and fatigue, so I went to a small clinic.
The doctor diagnosed me with gastritis symptoms.
After taking the medication, I initially felt better, but the next day I had stomach and abdominal pain.
I checked the side effects of the medication, which mentioned gastrointestinal discomfort, so I returned to the clinic.
The doctor then said it was acute gastroenteritis.
I continued to visit for follow-up appointments and took medication for about three weeks, but my symptoms did not improve.
I underwent an endoscopy, which revealed mild erosion and gastroesophageal reflux, but I also experienced pain below my navel.
I became increasingly anxious, which may have contributed to my symptoms, as I would suddenly wake up at night in pain, experience frequent urination, and have chest tightness.
I went to Taipei City United Hospital, where I had a CT scan, stool tests, and an abdominal ultrasound, all of which came back normal.
Despite taking medication for a long time without improvement, the director suggested it was a functional issue.
After relaxing, my symptoms improved somewhat, but I still feel a sensation of acid in my throat, occasional bloating, and intermittent abdominal pain.
Doctor, how can I improve my condition? I frequently went to the hospital for tests during that time.
Is there really such a thing as a functional issue? Thank you, doctor.

Xiao Chen, 30~39 year old female. Ask Date: 2017/01/26

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If all tests show no obvious issues, it may be necessary to look for causes in your lifestyle, diet, and habits.
Avoid stimulating foods (such as tea, coffee, fried foods, and spicy foods), try not to be overly anxious or under significant stress, and develop a habit of daily bowel movements to prevent constipation.
If there is no improvement, it is recommended to return for a follow-up with a gastroenterologist.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2017/01/26

More Info

Functional gastrointestinal disorders (FGIDs) are a group of conditions characterized by chronic gastrointestinal symptoms that cannot be explained by structural or biochemical abnormalities. Your journey through various medical evaluations and treatments is quite common among patients experiencing FGIDs. It can be frustrating and exhausting, especially when symptoms persist despite numerous tests and treatments.

From your description, it seems you have experienced a range of symptoms, including stomach pain, dizziness, and feelings of anxiety, which have led to multiple visits to healthcare providers. Initially, you were diagnosed with acute gastroenteritis, but after further evaluations, including an endoscopy and imaging studies, the diagnosis shifted towards functional issues, particularly related to your gastrointestinal tract.

Understanding Functional Gastrointestinal Disorders
FGIDs, such as functional dyspepsia and irritable bowel syndrome (IBS), are often linked to a combination of factors, including:
1. Visceral Hypersensitivity: This refers to an increased sensitivity of the gastrointestinal tract to stimuli, which can lead to pain and discomfort.

2. Altered Gut Motility: Changes in how the intestines contract can lead to symptoms like bloating, pain, and altered bowel habits.

3. Psychological Factors: Stress, anxiety, and depression can exacerbate gastrointestinal symptoms. Your experience of anxiety and its impact on your symptoms is a crucial aspect of FGIDs.

4. Dietary Factors: Certain foods can trigger symptoms in sensitive individuals. Keeping a food diary may help identify any potential triggers.

Treatment Strategies
1. Dietary Modifications: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may help alleviate symptoms, especially if you have IBS. It's also beneficial to maintain a balanced diet rich in fiber, which can help regulate bowel movements.

2. Medications: Depending on your specific symptoms, various medications may be prescribed:
- Proton Pump Inhibitors (PPIs): These can help manage acid reflux symptoms.

- Antidepressants: Low-dose antidepressants can help manage pain and improve gut motility.

- Antispasmodics: These can relieve cramping and abdominal pain.

- Anxiolytics: If anxiety is a significant factor, medications to manage anxiety may be beneficial.

3. Psychological Support: Cognitive-behavioral therapy (CBT) and other forms of psychological support can be effective in managing the anxiety that often accompanies FGIDs. Mindfulness and relaxation techniques may also help reduce stress and improve your overall well-being.

4. Regular Exercise: Engaging in regular physical activity can help improve gut motility and reduce stress levels, which may alleviate some of your symptoms.

5. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment as necessary. If your symptoms persist or worsen, further evaluations may be warranted.

Conclusion
Your experience is a testament to the complexity of functional gastrointestinal disorders. It is indeed possible to have a functional issue that does not show up on standard tests. The key is to work closely with your healthcare provider to develop a comprehensive management plan that addresses both the physical and psychological aspects of your symptoms. Remember, you are not alone in this journey, and many patients face similar challenges. With the right approach, it is possible to improve your quality of life and manage your symptoms effectively.

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