Functional GI Disease: dyspepsia, IBS, dyskinesia

General Information
The normal function of the digestive tract is marvelously coordinated. Food and fluids enter at the top for digestion and absorption. The waste moves smoothly down the digestive tract for timely elimination. Not surprisingly, in some people a certain amount of incoordination in this process occurs. These people do not have changes in their anatomy as a cause of this difficulty, nor do they have ulcer, tumor, or inflammation. This may involve the esophagus (the swallowing tube), the stomach, the small intestine, the colon (the large intestine), or the gallbladder and biliary ducts. The change is in function; hence it is called functional gastrointestinal disease. Other names include noncardiac chest pain, functional dyspepsia, biliary dyskinesia, irritable colon syndrome, irritable bowel syndrome, mucous colitis, and proctalgia fugax.

Functional gastrointestinal disease can affect persons of any age. Elderly patients are not exempt. It is variable in its occurrence. Patients commonly experience long periods that are symptom free, punctuated by attacks of the problem that may last for days, weeks, or occasionally months. Although stress seems to initiate the attack, it is less likely that it is the cause; stress simply makes an underlying problem slightly worse so that it becomes apparent.

Noncardiac chest pain resembles the discomfort that occurs with angina or a heart attack but which comes from the esophagus. It is a common problem. Diagnosis requires special testing of the function of the esophagus.

Functional dyspepsia resembles the discomfort associated with gastritis (inflammation in the stomach) or peptic ulcers. It occurs in the absence of ulcers or inflammation.

Biliary dyskinesia is a problem that resembles the difficulty that occurs with gallstones. There is pain and discomfort in the right side of the abdomen. It occurs in the absence of actual gall stones.

Irritable colon syndrome presents as a change in bowel habit, most often diarrhea, although diarrhea alternating with constipation does occur. Many people also experience a crampy abdominal pain, although a pain of this variety also occurs with simple diarrhea. Attacks are often abrupt in onset.


Important Points in Treatment
Treatment involves using medications to attempt to normalize the digestive tract function. If cramps are a problem, antispasmodic drugs are often helpful. If painless diarrhea is a problem, antidiarrheal drugs may correct the symptoms. The addition of a fiber supplement to the diet often benefits patients whose diffi- culty follows either pattern. These are symptomatic treatments. When stress plays a role in the development and continuation of the problem, programs and medications for stress management are helpful.

With biliary dyskinesia it may be possible to relieve the problem by opening the end of the bile duct with an instrument.

Selection of the proper drug or treatment is essential. Your physician will discuss with you the potential diagnoses and needed tests.

Notify Our Office If ...

• You have a sudden onset of chest pain.
• You develop persistent dyspepsia.
• You begin to experience pain in the right upper abdomen, particularly if associated with nausea, vomiting, or intolerance to fatty foods.
• You have a change in bowel habit.