Functional Gastrointestinal Disorders (FGID) are the most common G.I. condition diagnosed in the U.S, affecting around one in four people. In functional G.I. disorders, the gut-brain interaction is impaired, causing a range of symptoms from diarrhea or constipation, bloating, and abdominal pain. Unfortunately, standard medical tests such as C.T. scans and blood tests tend to return negative results, even when there is no doubt that the symptoms are real. While psychological factors, including stress and anxiety, can make the symptoms worse, these functional disorders are not psychiatric disorders.
The three most common functional gastrointestinal disorders are irritable bowel syndrome, functional dyspepsia, and functional constipation. Irritable bowel syndrome, or I.B.S, is the most common, affecting between 25 and 45 million Americans.
Irritable bowel syndrome (I.B.S.)
I.B.S. is a functional disorder that causes abdominal pain and abnormal bowel habits. Some patients have diarrhea-predominant symptoms (IBS-D); others suffer mostly from constipation (IBS-C). The condition affects women more than men and is thought to be triggered by food intolerances, stress, and hormonal imbalances. Sometimes a severe G.I. infection can lead to ongoing I.B.S. symptoms.
Functional Dyspepsia patients have recurring indigestion symptoms, including belching, bloating, and nausea. The symptoms match those of an ulcer, and risk factors such as smoking, anxiety, and depression can make the condition worse.
Also known as chronic idiopathic constipation, functional constipation has no physical or physiological cause. Symptoms can be similar to IBS-C but without the abdominal pain.
Sadly, many patients suffering from these G.I. disorders are not well served by traditional medicine, with a high percentage choosing not to consult physicians. As a functional medicine practitioner, I work with my patients to uncover the root cause of their condition, developing a unique treatment regime for each of my patients based on their specific situation. For some, this could involve testing for food intolerances; for others, relaxation therapy and a mindfulness program.
Gastrointestinal Autoimmune Diseases
Gastrointestinal Autoimmune Diseases such as Ulcerative Colitis, Crohn’s Disease, and Celiac Disease are known as structural diseases because there is identifiable damage to the G.I. tract.
Inflammatory Bowel disease
The two most common Inflammatory Bowel diseases are Ulcerative Colitis and Crohn’s Disease. Ulcerative Colitis (U.C.) causes ulcers to form in the colon and rectum, and patients suffer from stomach pain, diarrhea, and fatigue. Diagnosis is often made through blood that is present in the stool.
Crohn’s disease is more common than U.C. and causes inflammation of the digestive tract. The symptoms are similar to U.C. and can vary from mild to severe.
Treating Ulcerative Colitis
Patients with Ulcerative Colitis tend to move between flare-ups, where symptoms are bad, and remission, where symptoms are absent. The key to ongoing treatment is reducing inflammation and minimizing flare-ups. Alongside medicinal treatments, I provide my patients with complementary therapies that help reduce stress and support the mind and body through these challenging flare-ups.
Treating Crohn’s Disease
There is no single treatment for Crohn’s disease, and it is vital to work with a physician who can find the approach that works best for you. Traditionally, the condition is managed through a combination of medicines, bowel rest, and surgery in severe cases. There are many complementary therapies I recommend to my patients, including:
- Restoration of the gut biome through prebiotics and probiotics
- Exercise programs such as yoga
- Supplements such as turmeric, pineapple extract, fish oil, and aloe vera
- A temporary low fodmap diet
Celiac disease is an autoimmune disease where eating gluten leads to damage in the small intestine. It is estimated to affect about 1% of the U.S. population, with many cases going undiagnosed. Gluten can be found in food products containing wheat, barley, and rye. Many processed foods have gluten in them, making meals and snacks particularly challenging for celiacs.
Symptoms of Celiac Disease
Like I.B.S., Celiac stems from a severe intolerance to gluten. Unlike I.B.S, Celiac disease damages the lining of the small intestine and can lead to severe complications. Typical symptoms include:
- Weight loss
- Bloating and gas
- Abdominal pain
- Nausea and vomiting
Damage to the intestinal wall means nutrients cannot be absorbed efficiently, leading to possible growth and development issues for children in particular. Celiac disease has a strong hereditary element and is also more common in patients with type 1 diabetes, microscopic colitis, and autoimmune thyroid disease.
Diagnosing Celiac Disease
To diagnose celiac disease, we start with a blood test for specific antibodies. Elevated levels can suggest a gluten sensitivity. If positive, this blood test would be followed up with an endoscopy procedure to inspect the small intestine and take a small tissue sample to analyze for damage.
I always request that my patients don’t eliminate gluten from their diet before these tests take place; otherwise, the results could return a false negative.
While Celiac disease cannot be cured, a strict gluten-free diet will allow the intestinal wall to heal and reduce symptoms.
Food intolerances account for a significant number of gastrointestinal complaints. They are often related to an underlying condition such as I.B.S or celiac disease. Intolerances should not be confused with food allergies—food intolerance is a digestive system response, whereas allergies are an immune system response. Lactose intolerance is the most commonly diagnosed intolerance, affecting up to 10 percent of the U.S population. Generally, diagnosis is achieved by keeping a food diary or undergoing an elimination diet.
An Integrated Approach to the Treatment of Gastrointestinal Disorders
As conventional therapies fail them, more and more patients are turning to functional medicine for more individualized care that is less ‘disease-focused.’ There is greater recognition now that the rise in these FGID’s has a basis in societal and environmental pressures. We are putting increased stress on our bodies and minds. As a practicing functional medicine physician in Arlington VA, I bring together the best of traditional and alternative medicine to ensure my patients receive the medical care they deserve.
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