Functional Gastrointestinal Relief

Two functional gastrointestinal conditions, perhaps related, are functional dyspepsia (FD) and irritable syndrome (IBS). Many patients with either of these conditions also experience symptoms of the other condition.

These conditions are similar in that symptoms are typically chronic in nature, may wax and wane, and may worsen following meals. Characteristically, these complaints are sporadic, poorly localized, and without consistent identifiable aggravating or relieving factors. Psychosocial stressors play a role in both ailments. In addition, diagnosing these disorders may be challenging and take some time; a detailed history is central to the diagnosis, and extensive testing is unlikely to be helpful except to rule out other disorders. The similarities between IBS and FD raise the issue as to whether they are just different manifestations of the same disorder or whether they represent distinct clinical entities.
³ My personal view is that they represent different points along a continuous spectrum that may generally termed functional gastrointestinal disorders.

Functional Dyspepsia (FD)

FD, previously known as non-ulcer dyspepsia, is a sensory and motility problem of the digestive tract, where sensation and peristalsis – the normal downward pumping and squeezing of the esophagus, stomach, and duodenum – are disturbed. This leads to what is sometimes called visceral hyperalgesia, or amplified sensation, especially of unpleasant feelings; and impaired distensibility or uncoordinated and even ineffectual emptying of the upper gut, with resulting symptoms of pain, fullness, and bloating and inability to finish full meals. Around 20-29% of Canadians have FD but only a small number will consult a doctor.

Irritable Bowel Syndrome (IBS)

IBS affects approximately 20% of the Canadian population. Symptoms include abdominal pain, bloating and gas, constipation and/or diarrhea, sometimes alternating between the two stool consistencies. Defecation usually temporarily relieves the abdominal discomfort. At present, many gastroenterologists classify IBS as a distinctly separate functional bowel disorder from dyspepsia. However, upper gastrointestinal (GI) function regularly affects lower GI tract function, and vice versa.⁴ A recent study found delayed gastric emptying in patients with overlapping IBS and FD symptoms, whereas patients with IBS alone had emptying rates similar to those of healthy controls.⁵

Treatment

The prime goal of therapy for functional GI conditions is to alleviate the patient’s pain and discomfort and then to relieve secondary symptoms including bloating and upper abdominal fullness in patients with dyspepsia; and constipation, bloating, diarrhea, and urgency in patients with IBS. Education helps patients understand why their symptoms are occurring. Patients also benefit from reassurance that pathology that is more serious has been ruled out.

For more information on treating dyspepsia and IBS with dietary and lifestyle modifications and/or medications, please contact the CSIR office. This article is focusing on a phytopharmaceutical (plant medicine) consisting of plant extracts used to treat both the upper and lower GI conditions of functional dyspepsia and IBS, called Iberogast® (STW 5).