Functional Gastrointestinal and Motility Disorders (FGID)
Functional Gastrointestinal conditions are a group of problems related to the connection between the gut and brain. There is no structural damage accompanied with FGID’s. Consequently, medical tests and explorations will often produce insignificant, ‘normal’ results. FGID are not mental health conditions. Still, stress and overwhelm can exacerbate these conditions. This information sheet by UNC School of Medicine provides an overview of functional gastric issues.
Biological, social and psychological factors all impact the development and management of FGID’s. For example, how you learned to cope as a young child, current life stressors, genetics, how the brain interprets signals from the body and how the muscles in your gut fire, are just some of the sub-factors involved in FGID’s.
This image taken from the Clinical Medicine Journal explains this in more detail:-
Explore the following information sections to find out more about the most common FGID’s:
Functional Abdominal Pain
Alternative names include Centrally Mediated Abdominal Pain Syndrome (CAPS), Functional Abdominal Pain Syndrome (FAPS) or Chronic Functional Abdominal Pain (CFAP).
FAP occurs when there is no detectable inflammation or structural issues related to the abdomen, yet there is recurrent pain in the abdominal area.
Often this can c-occur with other functional GI symptoms (return to previous webpage for more information).
External Resources
Centrally Mediated Abdominal Pain Syndrome (CAPS) - IFFGD
What is Functional Dyspepsia?
Functional Dyspepsia (FD), is a condition linked to the gut-brain connection. Symptoms can include abdominal pain, bloating, feeling full quickly and burping. When there is no explicit cause of dyspepsia (or indigestion) such as inflammation or ulceration of the digestive system, it is called functional dyspepsia.
The exact cause of FD is unknown. However, there are many factors that can lead to FD symptoms including:
This information leaflet provides further information on the digestive system, FD and treatment.
Living with Functional Dyspepsia
Because functional indigestion is linked to the gut-brain connection, it is important to look after your mental health and stress levels. This webpage explains little bit more about the gut-brain link and how your digestive system can be impacted by stress.
Functional dyspepsia can also be helped through dietary intake. This patient informational leaflet by NHS University College London Hospitals provides some information on how and what to eat with FD. A reminder that this is provided for information purposes only and professional medical opinion should be sought before making any changes.
The external resources and self help pages below provide further information on FD, the gut-brain link, managing stress and difficult emotions.
The Gut Stuff - Further information on the link between the brain and gut.
Webpage: The Brain: All About The Gut-Brain Axis - The Gut Stuff
NHS Lothian- Information video on functional dyspepsia by NHS Lothian Professionals
Webpage: Functional Dyspepsia – Gastroenterology (nhslothian.scot)
Guts UK- information on FD from the Guts Charity. A charity focussed on funding research projects into the diagnosis and treatment of conditions of the digestive system.
Webpage: Functional Dyspepsia - Guts UK (gutscharity.org.uk)
NHS Inform- NHS information on indigestion more generally.
Webpage: Indigestion - Illnesses & conditions | NHS inform
Gastroesophagaeal Reflux Disease (GORD or Functional Heartburn)
What is GORD?
GORD or functional Heartburn involves a burning sensation in the chest. Usually, the burning pain comes and goes, and is common after eating a meal. There can be other symptoms alongside including burping, bloating and sensations of fullness.
GORD is thought to be caused in the following two ways. Some people can develop a hypersensitivity to the appropriate levels of acid in their stomach, or they could have inappropriately high levels of acid. More commonly, the specific cause of GERD is unknown but is linked to biopsychosocial factors discussed in the GI introduction page (please hyperlink underlined text back to Functional GI page).
Living with GORD: Stress & Mental Health
Just like other functional conditions, because GERD is linked to the gut-brain connection and is impacted by psychological and social factors, it can be important to look after your mental health and stress levels. This webpage explains little bit more about the gut-brain link and how stress can impact your digestive system.
About GERD – Information on signs, symptoms, treatment and managing GERD.
Webpage:- www.aboutgerd.org
NHS inform – Further information and support for managing GERD.
Webpage:- Gastroesophageal reflux disease | NHS inform
What is Functional Vomiting and Nausea?
3 kinds of functional vomiting including cyclic vomiting syndrome (CVS), functional vomiting (FV) and chronic idiopathic nausea (CIN).
Cyclic Vomiting Syndrome
CVS involves periods of intense vomiting that usually last less than one week, but occur at least 3 times a year. These symptomatic episodes are interspersed with periods of no vomiting.
A quarter of people experiencing CVS also have family or persona history of migraines. Triggers can also include bright lights, sleep deprivation and getting too hungry.
This video explains cyclic vomiting in more detail:
CVS is a relatively new area of research and therefore there are minimal evidence-based treatments available to manage or treat the symptoms. This NHS webpage provides some helpful information on how to treat CVS. For more in depth material, the UK Cyclic Vomiting Association has a treatment information page. This page outlines the current guidelines when treating CVS.
Functional Vomiting
FV is a rare condition which involves regular vomiting that occurs in no particular pattern.
Chronic Idiopathic Nausea
CIN is when the main symptom is feeling nauseous. It usually occurs without vomiting
Living with functional vomiting or nausea
Overall, because functional conditions related to vomiting and nausea are fairly new areas of research, evidence-based treatments are still in development. Therefore, if you have symptoms related to functional vomiting or nausea, and this is causing you significant distress, it is important to speak to a health professional.
There are also ways to manage the emotional and mental challenges that can exist alongside a long term condition. Please refer to the self help and external resources section of the gastrointestinal section. (Can you link ‘self help’ to the self-help section as described please).
NHS – Information on cyclic vomiting syndrome including phases of the cycle, diagnosis, treatment and management
Webpage:- Cyclical vomiting syndrome - NHS (www.nhs.uk)
Cyclic Vomiting Syndrome Association UK – A charity offering support and information for people and carers experiencing the impact of CVS
Webpage:- CVSA | cvsa uk – Charity Number: 1045723
The Migraine Trust – Charity for people living with migraines including information page on CVS
Webpage:- Cyclical vomiting syndrome - The Migraine Trust
What is Gastroparesis?
Gastroparesis is when the movement of food from your stomach to your small intestine slows or stops. This happens because the muscles of the stomach which work to breakdown food, contract less often and/or weaker than usual.
It is often very difficult for doctors to find an exact cause of a person’s gastroperisis. Because the nervous system, in particular the Vagus nerve, sends signals to and from your stomach and small intestine, conditions that impact the nervous system can also lead to gastroperisis. The condition is also four times more common in women than men.
Some causes include:-
Living with Gastroparesis
Treatment and management of the condition varies depending on the person and depends upon the cause of symptoms. There is usually a focus on nutrition and weight management as well as a reduction of symptoms.
Research is still emerging in this area and is therefore often based on clinicians experience with patients.
NHS - Gastroparesis - NHS (www.nhs.uk)
NIK - Gastroparesis - NIDDK (nih.gov)
What is Functional Constipation?
Functional constipation is when someone has irregular and sometimes, painful bowel movements. It is usually a condition based on exclusion of other symptoms and illnesses.
Functional constipation can be influenced by psychological and behavioural components, but is usually a combination of factors.
Here is a more in depth article providing a summer of the causes, symptoms and treatments of constipation.
There are three kinds of functional constipation:
Living with Functional Constipation
Some of the changes that can help with constipation include nutrition and adapting your toilet routine.
Nutritional tips include ensuring you keep hydrated, eating enough fibre (30g per day), and eating fruits high in sorbitol.
When thinking about your toilet routine, it is important to have a regular time and space to go when you need to go. This article provides more information with a comical slant.
Regular exercise can also help some people with slow bowel movements.
NHS – Information on constipation generally from NHS
Webpage - Constipation - Illnesses & conditions | NHS inform
Nature Reviews Journal – an article exploring the evidence around the management of functional constipation
Webpage:- Management of functional constipation in children and adults | Nature Reviews Gastroenterology & Hepatology
Blog article on constipation – written by a pelvic physiotherapist
Webpage:- Easing the strain: put your feet up for constipation - Evidently Cochrane
NICE – self-management guidelines for constipation generally, by National Institute for health and care excellence
Webpage:- Scenario: Adults | Management | Constipation | CKS | NICE
GUTS UK – charity advocating for the funding and treatment of gastrointestinal conditions.
Webpage:- Constipation | Causes, Symptoms, Treatment & Support | Guts UK (gutscharity.org.uk)
What is Functional Diarrhoea?
Diarrhoea is characterised by the frequent passing of very soft stools. It can be classed as functional when there is no known abnormality showing up during physical and laboratory examination. This leaflet by West Suffolk NHS Trust provides a further overview of information about diarrhoea.
Functional diarrhoea can be a part of IBS, however IBS is usually ruled out if diarrhoea is not accompanied by abdominal pain.
Medication, prior digestive tract surgery, and nutritional factors need to be considered during diagnosis as these could be contributory factors.
Whilst the causes of FD are not entirely clear, gut motility, including the functioning of the muscles within the gastrointestinal tract is thought to be one factor.
Living with Functional Diarrhoea
Because there is no clear cause of FD, treatment focuses on symptom alleviation.
Managing through nutritional intake is one key focus of treatment. For example, this can include the removal of food groups that include lactose, caffeine and fructose. As always, it is important to seek medical advice and a proper diagnosis before making any changes to your diet.
International Foundation for Gastrointestinal Disorders – Information on symptoms and treatment of FD.
Webpage:- Understanding Chronic or Functional Diarrhea - IFFGD
IFFGD – patient perspective on living with diarrhoea
Webpage:- Anne Sirota 2021 NES Patient Perspective on Diarrhea - YouTube
Self Help Resources
Because of the link between body and mind, developing an awareness of our mental health, stress responses and factors that impact our stress levels can often help manage physical symptoms, alongside any other appropriate medical treatment you might receive.
Below are a variety of self-help resources. These include information and work booklets on stress, relaxation and understanding emotions. There also links directing you to courses and guided support, run by NHS Fife psychology staff.
Mood Cafe Resources
Mood cafe is run by NHS Fife psychology team, providing information and resources to help you understand and improve your mental health. Whilst you are currently within the gastrointestinal section, the links listed below take you to other areas of the website that provide information that could support you in managing your gastrointestinal symptoms.
Click on each link to find out more:
Managing Emotions: Mood Cafe | Managing Emotions
Managing Anxiety, Panic and Stress: Mood Cafe | Anxiety and Panic attacks
Signs of Stress: Mood Cafe | Stress
Relaxation Exercises: Mood Cafe | Relaxation Exercises
Access Therapies Resources
Access Therapies is another branch of the Fife Health and Social Care Partnership’s psychology service, providing a range of free psychological therapies to people in Fife.
Listed below, are specific links to different parts of the site, including self help guides, online groups and guided self help courses. Please click on each link to find out more.
Self Help Guides: Self-Help Guides - Access Therapies Fife NHS (scot.nhs.uk)
Guided Self Help: Guided Self-Help Service - Access Therapies Fife NHS (scot.nhs.uk)
Adult Groups: Adult Groups - Access Therapies Fife NHS (scot.nhs.uk)
Finally, beyond Fife there are other useful websites providing information and resources linked to understanding and working with your mental health.
Explore the links to access free, evidence-based resources that you can work through at your own pace and time.
CCI Self Help Resources: CCI - Self Help Resources for Mental Health Problems