Functional and motility disorders (FGIDs) are a group of conditions that affect the gastrointestinal (GI) tract. These disorders are characterized by abnormal GI function, which can lead to a variety of symptoms, including abdominal pain, bloating, diarrhea, and constipation.

How Functional and Motility Disorders Present Themselves

FGIDs can present in a variety of ways, and the symptoms can vary from person to person. Some common symptoms of FGIDs include:

• Abdominal pain: This is the most common symptom of FGIDs. The pain can be located anywhere in the abdomen, and it can be cramping, burning, or sharp.
• Bloating: This is a feeling of fullness or pressure in the abdomen.
• Diarrhea: This is loose, watery stool that occurs more often than usual.
• Constipation: This is hard, dry stool that is difficult to pass.
• Other symptoms: Other symptoms of FGIDs can include nausea, vomiting, heartburn, and gas.

Common Scenarios

People with FGIDs may experience the following scenarios:

• Needing to avoid eating certain foods due to their symptoms.
• Having difficulty traveling due to the need to use the bathroom frequently.
• Experiencing anxiety or depression due to the challenges of living with a FGID.

How You Can Help Yourself

There are several things you can do to help yourself manage FGIDs, including:

• Lifestyle changes: Certain lifestyle changes can help to improve your symptoms, such as eating a healthy diet, exercising regularly, and managing stress.
• Medications: There are a number of medications that can help to control the symptoms of FGIDs.
• Therapy: Cognitive-behavioral therapy (CBT) can help to identify and change negative thoughts and behaviors that may be worsening your symptoms.

Why Do People Get Functional and Motility Disorders?

The exact cause of FGIDs is unknown, but they are thought to be caused by a combination of factors, including:

• Genetics: Some people are more likely to develop FGIDs if they have a family history of the condition.
• Stress: Stress can worsen the symptoms of FGIDs.
• Diet: Certain foods can trigger symptoms in people with FGIDs.
• Gut microbiota: The gut microbiota is the community of bacteria that live in the gut. Changes in the gut microbiota have been linked to FGIDs.
• Motility abnormalities: Motility abnormalities are problems with the way the muscles of the GI tract contract and relax. These abnormalities can contribute to symptoms such as abdominal pain, bloating, diarrhea, and constipation.

Who Gets Functional and Motility Disorders?

FGIDs can affect people of all ages, but they are most common in adults between the ages of 18 and 50. They are slightly more common in women than men.

Symptoms of Functional and Motility Disorders

The symptoms of FGIDs can vary from person to person, but some of the most common symptoms include:

• Abdominal pain
• Bloating
• Diarrhea
• Constipation
• Nausea
• Vomiting
• Heartburn
• Gas

How FGIDs Can Affect Lifestyle

FGIDs can have a significant impact on a person's lifestyle. The symptoms can make it difficult to eat, sleep, and work. They can also lead to anxiety and depression.

What Can You Do to Treat Functional and Motility Disorders?

There is no cure for FGIDs, but there are a number of treatments that can help to manage the symptoms. Treatment options will depend on the individual's symptoms and needs, and may include:

• Lifestyle changes: Certain lifestyle changes can help to improve symptoms, such as eating a healthy diet, exercising regularly, and managing stress.
• Medications: There are a number of medications that can help to control the symptoms of FGIDs.
• Therapy: Cognitive-behavioral therapy (CBT) can help to identify and change negative thoughts and behaviors that may be worsening symptoms.
• Surgery

Diagnosing Functional and Motility Disorders

How is FGID diagnosed?

Diagnosing FGIDs typically involves a combination of medical history, physical examination, and diagnostic tests.

• Medical history: Your doctor will ask you about your symptoms, including when they started, how severe they are, and how they affect your daily life. They will also ask about your medical history, including any family history of FGIDs or other gastrointestinal (GI) conditions.
• Physical examination: Your doctor will perform a physical examination to check for any signs of FGIDs, such as abdominal tenderness or bloating.
• Diagnostic tests: There are a number of diagnostic tests that can be used to help diagnose FGIDs. Some common diagnostic tests include:
  • Stool tests: Stool tests can be used to check for infections, parasites, and other conditions that can cause symptoms similar to FGIDs.
  • Blood tests: Blood tests can be used to check for anemia, thyroid problems, and other conditions that can affect GI function.
  • Imaging tests: Imaging tests, such as X-rays, ultrasound, and CT scans, can be used to look for abnormalities in the GI tract.
  • Endoscopy: Endoscopy involves inserting a thin, flexible tube with a light and camera at the end (endoscope) down the throat and into the stomach and small intestine. This procedure can help to visualize the lining of the GI tract and identify any abnormalities.
  • Manometry: Manometry is a test that measures the pressure and contractions in the esophagus or intestines. This procedure can help to identify motility abnormalities that may be contributing to symptoms.

What is the procedure for diagnosis?

The procedures used to diagnose FGIDs are typically performed on an outpatient basis, meaning you can go home the same day. The procedures are generally safe and well-tolerated.

• Stool tests: Stool tests are typically non-invasive and pain-free. You will be asked to provide a sample of your stool, which will be sent to a laboratory for analysis.
• Blood tests: Blood tests are typically non-invasive and pain-free. You will be asked to give a blood sample, which will be sent to a laboratory for analysis.
• Imaging tests: Imaging tests can vary in terms of how they are performed. For example, X-rays typically involve taking X-ray images of the abdomen, while CT scans involve lying on a table while a donut-shaped scanner rotates around your body to take X-ray images.
• Endoscopy: Endoscopy can cause some discomfort, but it is generally not painful. You will be given medication to relax your throat, and the endoscope will be inserted down your throat and into your stomach and small intestine. The doctor will then use the endoscope to visualize the lining of your GI tract.
• Manometry: Manometry can cause some discomfort, but it is generally not painful. You will be asked to swallow a thin tube with a pressure sensor at the end. The tube will be placed in your esophagus or intestines, and the pressure sensor will measure the pressure and contractions in your GI tract.

How long does it take to diagnose FGIDs?

The time it takes to diagnose FGIDs can vary depending on the availability of diagnostic tests and the expertise of Mr Veeramootoo. In most cases, FGIDs can be diagnosed within a few weeks.

Possible outcomes

The diagnostic tests used to diagnose FGIDs are moderately accurate. In one study, a combination of stool tests, blood tests, and endoscopy was 85% accurate in diagnosing FGIDs.

Pre-diagnosis and post-diagnosis

Pre-diagnosis

Before being diagnosed with an FGID, you may experience symptoms such as abdominal pain, bloating, diarrhea, and constipation. These symptoms can be caused by a variety of conditions, so it is important to see a doctor to get a diagnosis.

Post-diagnosis

After being diagnosed with an FGID, you will have the opportunity to discuss treatment options with Mr Veeramootoo. Treatment options will depend on the individual's symptoms and needs, and may include lifestyle changes, medications, and/or therapy.

Long-term effects

The long-term effects of FGIDs can vary depending on the severity of symptoms and response to treatment. With proper management, most people with FGIDs can live long and healthy lives.

FGID Surgery

Surgery is not a common treatment for FGIDs. However, it may be considered in some cases, such as when:

• Medications and other treatments have failed to control symptoms.
• There is a clear structural abnormality in the GI tract that is causing the symptoms.
• The symptoms are severe and are significantly affecting the person's quality of life.

The type of surgery for FGIDs will depend on the individual's symptoms and the underlying cause of the disorder. Some common types of surgery for FGIDs include:

• Partial colectomy: This surgery involves removing a portion of the colon. It is sometimes used to treat severe constipation or diarrhea.
• Ileostomy: This surgery involves creating an opening (stoma) in the abdomen to divert stool from the colon. It is sometimes used to treat severe colitis or Crohn's disease.
• Fundoplication: This surgery involves wrapping the upper part of the stomach around the lower part of the esophagus to help prevent acid reflux. It is sometimes used to treat gastroesophageal reflux disease (GERD).

What to expect after surgery

The recovery time from surgery for FGIDs will vary depending on the individual's overall health and the type of surgery performed. In general, people can expect to spend a few days in the hospital after surgery. They will need to follow a special diet and take medication to help prevent infection and promote healing.

Going forward after surgery

People who have had surgery for FGIDs will need to continue to see their doctor for regular follow-up appointments. They may also need to make lifestyle changes, such as eating a healthy diet and managing stress, to help prevent their symptoms from returning.

In most cases, surgery for FGIDs is successful in relieving symptoms and improving quality of life. However, it is important to note that surgery is not a cure for FGIDs and symptoms may return over time.

Conclusion

FGIDs are a common group of disorders that can have a significant impact on a person's quality of life. Treatment options will depend on the individual's symptoms and needs, and may include lifestyle changes, medications, and/or therapy. Surgery is not a common treatment for FGIDs, but it may be considered in some cases when other treatments have failed.