5 Integrative Ways to Treat Functional Gastrointestinal Disorders

Functional Gastrointestinal Disorders

"It's all in your head!" Has anyone ever said that to you? Functional gastrointestinal disorders (FGIDs) are a group of illnesses defined by recurrent and persistent gastrointestinal symptoms caused by the digestive tract's inability to perform properly. 

There are no structural (tumors or masses) or biochemical abnormalities that cause them. As a result, many common medical procedures used to detect an FGID, such as x-rays, CT scans, blood tests, endoscopic exams, and a physical examination, can yield results that are essentially normal/negative (non-disease). 

But you still have all of the common symptoms of a gut disorder. 

FGIDs can include functional bowel disorders, gastroesophageal reflux disease (GERD), peptic ulcer disease, and many other functional disorders. FGIDs exist even when there is no clear structural disease.

In this article, we will look at 5 integrative ways to treat functional gastrointestinal disorders.

A Note About Functional Gastrointestinal Disorders

There are more than 20 functional GI disorders that have been recognized in the general population. They can affect the esophagus, stomach, bile duct, and/or intestines, among other parts of the GI system. 

Irritable Bowel Syndrome (IBS) is the most common and well-studied FGID, characterized by stomach pain and abnormal bowel movements such as diarrhea, constipation, or alternating between the two. 

Functional dyspepsia (chronic abdominal pain or discomfort in the upper abdomen, sense of fullness, bloating, or nausea), functional vomiting, functional abdominal pain, and functional constipation or functional diarrhea are also typical FGIDs.

It's really important to remember that these are not psychiatric disorders, even if stress and psychological problems can exacerbate FGIDs. 

Functional gastrointestinal problems affect about 25 million people in the United States. 50 to 80 percent of those with FGID concerns do not seek medical help, and they report considerably higher workplace absence and disability than those who do not have these characteristic symptoms. 

IBS has been claimed to be the second greatest cause of missed work or school, after the common cold. FGIDs are phantom disorders that doctors often can't understand, but they make life a living hell for those who have them.

Do you have persistent functional symptoms and nothing is showing up on scans and blood panels? I would love to help you figure it out. Book a FREE call with me below.

Features of FGIDs

There are three main features of Functional Gastrointestinal Disorders: Motility, Sensation, and Brain-gut Dysfunction.

Motility

Motility refers to the normal muscle function of the intestinal tract, which is effectively a hollowed, tubular structure. 

Healthy motility causes an ordered succession of muscle contraction from top to bottom. FGIDs cause irregular motility, which often leads to painful muscle spasms. 

The contractions might be very fast, very slow, or unorganized. Erratic or spasmodic contractions indicate a motility problem and cause bowel irregularity. 

Activation of mast cells can generate epithelial and neuro-muscular dysfunction and promote visceral hypersensitivity and altered motility patterns in FGIDs.

Sensation

Sensation refers to the way nerves of the Gastrointestinal system respond to stimuli (e.g., digesting a meal). 

In the case of functional GI diseases, nerves in the GI tract might be so delicate that even regular contractions can cause pain or discomfort.

Brain-Gut Dysfunction

Brain-gut dysfunction refers to a communication breakdown between the brain and the gastrointestinal tract. The regulatory channel connecting brain and gut activity may be harmed by FGIDs.

Three general observations have emerged from research on the psychosocial elements of these disorders. 

For starters, psychological stress can aggravate gastrointestinal issues. The 'brain gut axis' is a bi-directional channel connecting the brain and the gastrointestinal tract. GI sensation, motility, and secretion can all be affected by external stressors, emotions, or ideas. To put it another way, the brain has an impact on the gut. However, activity in the gut can have a major impact on pain perception, mood, and behavior in the brain.

So, it isn't all in your head, but your head is definitely playing a role! 

That is part of the reason I have a holistic approach in my practice. We need to look at the gut, the brain, and the heart because these three things make up the whole of who we are, and our bodies are integrated. We will spend a year together, talking through how stress and trauma play a role in your symptomatology. This is as important as running labs to eradicate parasites.

Diagnosing Functional Gastrointestinal Disorders

Unfortunately, most FGIDs are not detected by normal testing used to diagnose common GI illnesses. 

A group of worldwide experts gathered in Rome in 1988 to talk about Functional Gastrointestinal Disorders. The purpose was to classify the FGIDs using a symptom-based classification scheme, emphasizing the fact that patients report symptoms even when there are no chemical, radiological, or physiological abnormalities that meet diagnostic criteria for a gut disorder. 

This resulted in the publishing of the Rome criteria (later known as Rome I) in 1992, which raised awareness of FGIDs among medical professionals. The "Rome Criteria," a series of symptom-based criteria devised by experts, is the primary way doctors diagnose Functional Gastrointestinal Disorders.

Oftentimes, a doctor will run a lower GI endoscopy if a patient has atypical IBS symptoms and an abnormal faecal calprotectin level (a substance released due to inflammation in your intestines), or if there are red flags that imply colon cancer. 

A gastroscopy may be run to look for h. pylori or dyspepsia in the absence of warning symptoms (such as chronic pain, vomiting, anemia, and weight loss in individuals under the age of 60).

Other causes of GI discomfort, such as celiac disease, inflammatory bowel disease, and intestinal blockage, are often ruled out by gastroenterologists when diagnosing FGIDs. One third of patients diagnosed with FGIDs have comorbidity with Postural orthostatic tachycardia syndrome (POTS). Patients are often disheartened when it comes to treatment because traditional medicine's understanding of these conditions is still improving and symptoms might differ between individuals.

I am passionate about the gut. I want to equip you to become your own gut expert so that you can get to the bottom of your symptoms. I put together a quick, 30-minute webinar that explains how the gut works. Click the link below to get your FREE copy.

Typical Treatment for Functional Gastrointestinal Disorders

Proton pump inhibitors (PPIs) and antidepressants are among the most common treatment recommendations given by health care providers for FGIDs.

Previous studies demonstrated drug treatment to reduce inflammation in the gut, which relieves symptoms. 

However, when used as the primary care for symptoms, these drugs rarely prove effective in the long run, and have a great effect on the overall health of the liver.

The liver performs a variety of critical activities, including assisting in the digestion of food as well as the processing and distribution of nutrients. 

It is essential to have a healthy liver in order to live. 

Scar tissue can form as a result of recurrent or long-term damage caused by medications. Cirrhosis, a disorder in which the liver is unable to function normally, can be caused by scarring of the liver. Cirrhosis of the liver is a prominent cause of death around the world.

Antidepressants also kill healthy gut bacteria that your digestive system desperately needs, resulting in nausea, vomiting, and diarrhea. 

In recent studies,  Scientists have looked at the antibacterial capabilities of various antidepressant medications on common gut microorganisms. They found that long-term use of antidepressants with antimicrobial effects is linked to the formation of adaptive changes in the gut microbiota, which could have negative consequences. 

Antidepressant antimicrobial activity against gut microbiota could be a side effect, but it could also be a mechanism of antidepressant function in the gut. It is critical to understand the impact and mechanisms of antidepressant antimicrobial action, as well as the ramifications for gut microbiota structure and metabolism.

Integrative Treatment for Functional Gastrointestinal Disorders

There are significant differences in the way a functional practitioner looks at GI symptoms related to Functional Gastrointestinal Disorders. 

Rather than medicating symptoms, the goal is to do a detailed history of physical symptoms and run diagnostic tests to determine the health of the gut microbiome. 

We screen for bacterial infections like helicobacter pylori (h. pylori), parasites, small intestinal bacterial overgrowth (SIBO), hormone imbalances and mineral deficiencies. These are all possible underlying causes of FGID symptoms. 

This doesn't mean we reject medicinal intervention altogether, but we want to work against long term side effects of traditional medicine that will harm the gut microbiota and lead to further complications. 

The fact is, there are several treatment options we can try before employing the use of a pharmaceutical drug. After a systematic review of your gut, we can assign specific diet and lifestyle changes, various healing protocols, and a supplement regimen that will have a large beneficial effect.

Integrative medicine promotes a holistic approach to mental health illnesses that draws on a variety of medical and nutritional disciplines. Patients regain mental wellbeing with tailored metabolic testing, nutritional therapy, and dietary changes during this process. These techniques can be combined with more traditional medical procedures, such as psychotherapy wherein the patient relationship with the therapist brings lasting internal healing. Nutritional deficiencies, food allergies, infections, toxicities, and genetic abnormalities are all examples of underlying biological concerns that can be evaluated and treated with relevant laboratory examination. Customized treatment strategies can be created to provide superior digestive health outcomes by concentrating on an individual's specific genetic, biochemical, and nutritional state.

Diet & Nutrition

FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are a type of short-chain carbohydrate that can be found in many of the foods we eat. They have three properties that make them more likely to induce GI distress: they are poorly absorbed in the intestine, they pull excess water into the intestines, and bacteria in the colon quickly ferment them. As a result, you'll have more gas, bloating, abdominal pain, and diarrhea. 

The goal of the FODMAP diet is to eliminate these types of food to allow inflammation in the gut to decrease. During the elimination phase, you eat only FODMAPS-free or low-FODMAPS items. 

Then, with the help of a functional health practitioner, we gradually reintroduce food categories in a systematic manner. Throughout this procedure, we will keep an eye out for signs and symptoms of GI distress. In the long run, just a few foods will need to be completely excluded from your diet.

Just like any diet (Whole30, paleo, keto, etc...), food is just one component of healing for FGIDs. You can't expect a diet to solve everything. If you have hormone imbalances, bacteria overgrowth, or parasites then the wrong diet could actually make your symptoms worse. That is why diagnostic testing is so important. If you’d like to learn more, here are the labs I recommend.

Acupuncture

FGID symptoms are thought to be caused by changes in pain modulation, motility, and autonomic function, which may have positive physiological reactions to acupuncture. 

Acupuncture has long piqued the interest of FGID patients due to its ancient roots and desire for non-pharmacological treatment, but it has also drawn the interest from FGID researchers. 

Acupuncture has been proven to increase gastrointestinal motility in both animal and human trials, including improved stomach emptying and accommodation. 

The recent study of functional dyspepsia, functional bloating, and nausea could be a logical extension of this research. Both functional dyspepsia and IBS are characterized by pain and/or discomfort. 

Acupuncture has been shown to modulate pain in two ways: by deactivating descending nociceptive (painful) pathways and by decreasing limbic activity during acupoint stimulation in brain imaging investigations.

Herbal Therapy

Herbal remedies are a safe, complementary alternative to traditional medicine. 

Iberogast (STW-5) and peppermint oil, which have primarily been studied and utilized in Europe, as well as rikkunshito and motilitone (DA-9701), which are taken from natural components in traditional medicine, are among the herbal medicines that are comparatively considered to help with FGIDs. 

These herbal medicines have a multi-target pharmacology that is similar to the etiology of FGIDs, such as altered intestine sensory and motor function, inflammation, and neurohormonal abnormalities, and they have shown comparable efficacy and safety in controlled trials.

Probiotics

Probiotics have been studied for their safety and efficacy, as well as their function in reducing symptoms and regulating bowel movement frequencies in individuals with chronic constipation or diarrhea due to IBS. 

A probiotic known as Bifidobacterium infantis has been shown to be useful in treating IBS, according to a review article published in The Journal of the American Dietetic Association in 2008. I recommend Dr. Ohhira's Probiotics Original.

While probiotics are helpful, it is crucial to get to the base of the problem, which could include food triggers, allergies, and psychosocial factors.

Psychotherapy

There are many psychological factors that contribute to GI symptoms in FGIDs. Psychological distress, anxiety disorders, and any other somatic symptom disorder play a role in perpetuating chronic symptoms. 

Patients with disorders of gut-brain interaction have abnormal physiological functioning, which is thought to be caused by underlying changes in GI motility (either too fast or too slow), visceral hypersensitivity, altered microbiota, increased intestinal permeability, low grade immune infiltration, and altered sensory input processing by the central nervous system. 

However, as observed in the biopsychosocial approach, symptoms and healthcare seeking are caused by a complex interplay between early life events, family history and coping methods, genetic factors, learned behavior, changes in GI physiology, and associated psychological illness. 

Psychotherapy can address behaviors, cognitions, and attitudes in addition to aberrant physiology or symptoms.

According to one previous study, chronic stress may worsen the severity and breadth of gastrointestinal, mental, and extraintestinal symptoms over time. 

Psychotherapy that targets specific aspects of chronic stress and its consequences may be most beneficial to FGID patients with multi-system symptomatology. However, early intervention, particularly in patients with functional dyspepsia and/or IBS, may prevent the development of such severe and extensive disorders.

Many patients experience exacerbations of symptoms as a result of stressful life events, and traumatic life events, such as sexual or physical abuse, are linked to an increased prevalence of IBS and other FGIDs. 

Patients with Functional Gastrointestinal Disorders are more likely to have comorbid psychiatric diseases such as generalized anxiety disorder and severe depression.

The brain has a strong influence on pain perception, motility, and secretion in the gastrointestinal tract. Comorbid anxiety is linked to a lower tolerance for gastrointestinal discomfort/pain and decreased gastric adaptation in functional dyspepsia, while depression is linked to greater postprandial distress, nausea, and vomiting. 

Stress decreases visceral pain thresholds and increases colonic and ileal (a portion of the small intestine) motility in IBS patients.

Hypnotherapy

While the specific mechanisms of gut-focused hypnotherapy in functional FGIDs are unknown, research shows that it can influence gastrointestinal function and physiology. 

Hypnotherapy has been found in controlled investigations in healthy adults to be able to influence stomach acid secretion, accelerate gastric emptying, and alter orocecal transit time (the time between the lactulose ingestion and a sustained increase in breath hydrogen) evaluated using the lactulose hydrogen breath test in the upper GI system. 

Similarly, some investigations in individuals with Irritable Bowel Syndrome have found significant variations in colonic sensory and motor function before and after hypnotherapy, revealing modulation of postprandial gastrocolic reflex activity, colonic motility, and visceral hypersensitivity.

Hypnotherapy is normally done on an individual basis by a qualified therapist over the course of 6 to 12 weeks in 30 to 60 minute sessions. 

Clinical hypnosis is a verbal technique that involves inducing a unique mental state of increased susceptibility to suggestion in order to assist therapeutic psychological and physiological changes. The goals of gut-focused hypnotherapy are to guide the patient to learn how to control their gut function by inducing a profound level of relaxation.

A New Way Forward

Functional bowel disorders and other Functional Gastrointestinal Disorders greatly reduce quality of life for those who have them. 

Leaving FGIDs to themselves also creates an increased risk of several diseases such as colorectal cancer.

If you or someone you know faces the common problems associated with Functional Gastrointestinal Disorders, it is time for an investigation of the gut. 

Early detection is our best strategy to prevent future issues. 

As always, I am just a phone call away. I would love to chat through your symptoms, hear your story, and see how I can help!

Talk soon,