FODMAP

Source: Peter R Gibson and Susan J Shepherd. Journal of Gastroenterology and Hepatology. 2009.

Functional gastrointestinal symptoms are common and their management is often a difficult clinical problem. The link between food intake and symptom induction is recognized.

The low FODMAP diet provides an effective approach to the management of patients with functional gut symptoms. The evidence base is now sufficiently strong to recommend its widespread application.The restriction of their intake globally (as opposed to individually) reduces functional gut symptoms, an effect that is durable and can be reversed by their reintroduction into the diet.

Functional gastrointestinal disorders

Source: Christine Dalton, PA. University North Carolina. "What is a Functional GI disorder?"

Functional gastrointestinal disorders (FGIDs) are common disorders that are characterized by persistent and recurring GI symptoms. These occur as a result of abnormal functioning of the GI tract. They are not caused by structural (tumors or masses) or biochemical abnormalities.

As a result, many routine medical tests attempting to diagnose an FGID, such as x  rays, CT scans, blood tests and endoscopic exams can have essentially normal/negative (non disease) results.

More than 20 functional GI disorders have been identified. They can affect any part of the GI tract, including the esophagus, stomach, bile duct and/or intestines.

The most common and best researched FGID is Irritable Bowel Syndrome (IBS): abdominal pain associated with altered bowel habits of diarrhea, constipation or alternating between both.

Other common FGIDs include functional dyspepsia (pain or discomfort in the upper abdominal area, feeling of fullness, bloating or nausea), functional vomiting, functional abdominal pain, and functional constipation or diarrhea.

It is important to understand that these are not psychiatric disorders, although stress and psychological difficulties can make FGID worse.

Approximately 25 million Americans have functional GI disorders. 50 - 80% of people with FGID symptoms do not consult a physician, although they may take over the counter medications and report significantly more job absenteeism and disability than people without these symptoms. It has been reported that IBS is the second leading cause, after the common cold, for missing work or school

Irritable bowel syndrome

Author : Dr Uri Ladabaum Professor of Medicine Gastroenterology University of California, San Francisco

2008-08-01

Overview

Irritable bowel syndrome (IBS), which is characterized by abdominal pain associated with altered bowel movements, is the classic “functional” gastrointestinal disorder.  Patients with functional disorders experience symptoms, but no abnormality can be found on physical examination or standard medical tests.  Functional disorders present challenges and can cause frustration for patients as well as doctors.  The lack of a diagnostic test raises the question of how much testing should be done to exclude other conditions that can present with the same symptoms.  Patients with IBS may feel discouraged if they receive messages such as “we don’t know what is wrong,” “nothing is wrong,” or “it is all in your head.”  If a diagnosis of IBS is made, patients may feel uneasy that another serious disease is being missed, but if a focused medical work-up is done, the likelihood of missing other serious underlying disease is very low.  IBS is a chronic condition with symptoms that can wax and wane, and no therapy is universally effective for all IBS patients.  Successful management rests on providing education regarding the current understanding of IBS, reassurance of the good long-term prognosis, a supportive doctor-patient relationship, judicious use of behavior modifications and available therapies, and emphasis on leading as normal a life as possible even if symptoms cannot be eliminated completely.