Functional gastrointestinal disorders

Functional gastrointestinal disorders (FGDs), the most common intestinal afflictions, are a collection of chronic digestive symptoms that are not explained by any detectable anatomic anomaly.

Irritable bowel syndrome (IBS), the most common FGD

FGDs encompass a set of symptoms such as IBS, constipation, diarrhea, functional bloating, and non-specific FGDs.

IBS alone affects 10% of the population and is distinguished from other FGDs by abdominal pain associated with constipation, diarrhea, or alternations between them. It often presents with abdominal bloating and a higher level of stress than the general population.

FGDs don’t spare children

In very small children, FGDs represent the most common gastrointestinal reason for a doctor’s visit. This includes baby colic with regurgitation and constipation problems, IBS, and other less well characterized functional problems. Stomach pain, bloating, diarrhea, and constipation are commonly associated with FGDs and can have major consequences on a child’s daily life. Stress and anxiety can also favor or prolong certain symptoms, particularly pain.

Disrupted communication between the intestines and the brain

The causes of IBS are still poorly understood. The risk of developing IBS increases five-fold after a bacterial infection causing acute diarrhea. It has been suggested that it could be related to dysfunction in the communication between the brain and the intestine, in conjunction with an imbalance in the intestinal flora. In the majority of cases, there is a loss of diversity among the bacterial species that make up the microbiota, with fewer positive bacteria and more harmful bacteria. This dysfunction causes intestinal motor problems: transit is slowed, the intestinal barrier is modified, and slight inflammation develops. It also causes hypersensitivity in the mucosa that makes normal phenomena, like the movement of intestinal gas, painful.

Promising data for probiotics

For adults, in addition to a controlled diet, treatment options include antispasmodics, laxatives, and antidiarrheals. In children, relaxation and hypnosis techniques, which can relieve pain, are preferred. Sometimes antispasmodics are also prescribed. To modify the microbiota, there are promising data currently available about probiotics, particularly bifidobacteria and lactobacilli, and about fecal transplants. However, large-scale clinical trials still have to be conducted to confirm each of these options. 

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