Functional Bowel Syndromes: Functional Dyspepsia / Irritable Bowel Syndrome / Functional Bloating / Functional Diarrhea / Functional Constipation |
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Functional bowel syndromes are constellations of upper and / or lower abdominal symptoms unexplained despite adequate medical examination. The commonest forms are functional dyspepsia (FD), irritable bowel syndrome (IBS), functional bloating, functional diarrhea and functional constipation. These syndromes are the focus of much exciting research and diverse etiological hypotheses exist. The most common theories are based on changes in sensation and in brain processing of pain (hypersensitivity), intestinal motility (muscle movement), intestinal permeability, enzyme or neurotransmitter function or chronic inflammation. Some of these changes can occur after an infectious illness or protracted and severe stress.
Food intolerances and allergies are observed much more frequently in patients diagnosed with functional bowel syndromes. Lactose or fructose intolerance, for example, is observed in between 50% and 70% of IBS, patients, respectively. Other frequently reported food reactions in functional bowel syndromes are increased symptoms after fatty, gluten or histamine-containing foods. At present it is unclear if food reactions and functional bowel syndromes are separate causes of the symptoms, or if they represent overlapping or just overlooked diagnoses. It has been shown that malabsorption of sugars is equally common in healthy individuals as it is in patients with functional bowel syndromes. The sugar malabsorption, however, leads to much more frequent and more intense symptoms of intolerance in patients with functional bowel syndromes. Furthermore, is has repeatedly been shown that dietary adaptations based on diagnosed food sugar intolerances can very significantly improve symptoms in IBS patients. Testing for food intolerances and, where indicated, food allergies, using validated methods is therefore currently recommended and is often beneficial in individuals with functional bowel syndromes. Further literature:
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