Functional Gastrointestinal Disorders

What will you discover?

• Definition
• Gastointestinal disorders in  few figures
• The link between gastrointestinal disorders, eating disorders and obesity
• Mechanism associated with gastrointestinal disorders
• Recommendations

Definition

FGID include functional esophageal disorders, functional gastroduodenal disorders, bowel disorders, central nervous system mediated gastrointestinal pain, gallbladder and sphincter of Oddi disorders, and anorectal disorders (see Figure 1). 

Gastointestinal disorders in  few figures

Recent studies conducted in 26 countries have shown that more than 40% of the general population suffers from at least one FGID. The high prevalence of females suffering from FGIDs (49%), shows that women are more likely to suffer from FGID compared to men (vs 37% in men). FGID can appear at a very early age, in fact a study found that 21% of children aged between 4 and 10 years old and 27% of adolescents aged between 11 and 18 years old suffer from FGID. The most common FGID are functional constipation (12%), functional dyspepsia *a (7%), proctalgia fugax*b (6%), functional diarrhea (5%), and irritable bowel syndrome *c (4%).

The link between gastrointestinal disorders, eating disorders and obesity

Mechanism associated with gastrointestinal disorders

Some studies also suggest that certain behaviors associated with ED, including vomiting, laxative abuse, and dietary restrictions , may play a role in the development of FGID, and conversely, some FGID, such as motor disturbances, may worsen typical ED symptoms, such as loss of appetite, self-induced vomiting, dysphagia, constipation and bloating. 

Recommendations

• Diet can play a major role in limiting the impact of FGID, on the quality of life. A recent study showed that FGID symptoms can be triggered by certain foods such as: spicy foods (80%), cow milk (54%), pizza (52%), soda (42%) or even cheese (36%). Moreover, foods mainly avoided by teenagers suffering from irritable bowel syndrome are fatty foods, dairy products and carbohydrates (bread, dough, cakes…).
  • Another study has shown that increased fish consumption may limit the development of symptoms associated with FGID, but these results need to be confirmed in a larger population. Numerous studies have investigated the association between the consumption of FOODMAPs (small carbohydrates that are poorly absorbed by the small intestine and therefore not easily digested) and FGID, but there is currently insufficient evidence in the literature to conclude.
  • Finally, especially in the presence of FGID, it is recommended to choose desserts that are not very or not at all processed (fruits, compotes) compared with processed foods that are generally rich in added sugar.
  • A minimally processed diet is alway to be favored over a diet high in ultra-processed food because several studies have associated the consumption of ultra-processed foods with different health risks such as FGID , like irritable bowel syndrome, some types of cancer, ED or even cardio-metabolic diseases (feel free to road our article on the subject of ultra-processed food.

Conclusion

• FGID are numerous and affect a large part of the population. Unfortunately, currently, there are no strict recommendations on the diet to adopt in case of FGID. Since dietary studies are very long and complicated to conduct and due to the discrepancies between the different forms of FGID and the heterogeneity of the individuals involved, there is currently little knowledge on the subject and no conclusions.
• A few studies provide preliminary results on the impact of diet on symptoms associated with FGID, but those studies must be conducted in different populations in order to be confirmed.
• In order to improve the quality of life of patients with FGID, a list of foods consumed before the onset of one or more symptoms can be compiled to identify, on the long term, foods that are particularly at risk.