Chronic Bloating, IBS or Something More? Understanding Functional GI Disorders

It is likely that many of us have experienced bloating, gas, or irregular bowels at some point in our lives. However, when these symptoms become a daily occurrence and begin to interfere with your day-to-day activities, eating habits, and sense of wellbeing, there may be more involved than just indigestion. You may warrant a diagnosis within a cluster of health conditions known as functional GI disorders. 

Let’s look more closely at functional GI disorders, how to differentiate them from structural diseases, and why it is important to understand functional gastrointestinal disorders for long-term gut health.

What Are Functional GI Disorders?

Functional GI disorders are conditions where the GI tract was normal upon examination/medical investigations such as endoscopy, scans, etc, but it is not functioning properly. This means you may not see evidence of inflammation, ulceration, or obstruction; however, the patient may be reporting discomfort, pain, bloating, or altered bowel habits. 

Functional GI disorders affect the way the gut and brain communicate with each other through a wide range of mechanisms, often referred to as the “gut-brain axis.” Disruptions in this communication can result in the gut misfiring signals of digestion leading to a variety of chronic symptoms. 

Common Types of Functional GI Disorders

Several well-known conditions fall under the umbrella of functional GI disorders, including:

1. Irritable Bowel Syndrome (IBS)

The most common of the group, IBS is characterized by abdominal pain, bloating, and changes in stool consistency or frequency. Subtypes include:

• IBS-C (constipation dominant)
• IBS-D (diarrhea dominant)
• IBS-M (mixed type)

2. Functional Dyspepsia

Often mistaken for chronic indigestion, this condition causes upper abdominal pain, early fullness, and discomfort after meals, even when there’s no evidence of ulcers or reflux.

3. Functional Constipation

Functional constipation refers to sustained infrequent bowel movements, hard stools, and/or straining, without a mechanical explanation.

4. Functional Bloating

Functional bloating is when you feel uncomfortable and bloated without eating much food, and tests suggest you do not have obstructive or fluid build-up issues. This feeling can arise mostly due to abnormal motility or hypersensitivity of the gut.

What Causes Functional GI Disorders?

There isn’t a single known cause, but multiple factors are believed to contribute, including:

• Gut-brain dysregulation: Abnormal signals between the brain and the gut nerves.
• Stress and anxiety: Mental health plays a strong role in gut sensitivity.
• Post-infectious changes: Some develop symptoms after a stomach infection.
• Food intolerances: While not the root cause, they may aggravate symptoms.
• Microbiome imbalances: Disruptions in the gut bacteria composition can influence digestion and inflammation.

Are They Dangerous?

While functional gastrointestinal disorders are not lethal, they can have a negative impact on your quality of life. For example, many patients express that they avoid social gatherings instead of asking about parking, or are experiencing difficulty sleeping, or have trouble with food or bathroom anxiety. In some cases, lack of proper symptom management prolonged over a period of time can cause nutritional degradation and mental health distress too.

Diagnosis: Why It’s Often Frustrating

The diagnosis of functional gastrointestinal disorders is very often a process of exclusion. Doctors may do a physical exam, blood tests, and possibly imaging or endoscopy to rule out inflammatory bowel disease (IBD: Crohn’s, Ulcerative colitis), celiac disease or infections. 

Because the gastrointestinal tract is "normal" in functional disorders, doctors typically use evidence entirely from the patient's history, and typically diagnose the condition based on the patient's symptom types, patterns, and individual criteria: Rome IV criteria.

This is why too many patients find themselves unable to convey their on-going symptoms to medical professionals and are described as dismissal or even disgust directed towards receiving an explanation or they being told everything "looks fine" when they know they don't feel fine. You should find a specialist that will take your functional disorder seriously and knows how to address it.

Treatment: A Multifaceted Approach

There’s no one-size-fits-all treatment for functional GI disorders. Instead, care is personalized and usually includes:

1. Dietary Modifications

• Low FODMAP Diet: Often used for IBS, it reduces certain fermentable carbs that trigger symptoms.
• Fiber Adjustments: For constipation or diarrhea, types and amounts of fiber are tailored.
• Food Sensitivity Tracking: Identifying triggers through elimination diets or food journals.

2. Medications

• Antispasmodics for cramping
• Laxatives or stool softeners for constipation
• Antidiarrheals
• Gut-brain neuromodulators (low-dose antidepressants)

3. Psychological Therapy

• Cognitive Behavioral Therapy (CBT) and gut-directed hypnotherapy have shown strong results, especially for IBS, by helping reset the brain-gut interaction.

4. Probiotics and Gut Health Support

Some strains of probiotics can help improve motility and reduce bloating, though results vary by individual.

When to See a Specialist

If you’ve been dealing with persistent GI symptoms like:

• Chronic bloating
• Irregular bowel movements
• Abdominal pain
• Feeling full too quickly
• Symptoms worsening with stress

Sitting on a diagnosis, self-treating, possibly covering up something worse or prolonging your situation, will delay a potential definitive diagnosis!  You want to seek out a specialist that can take your symptoms, further assess them, test as guided by the symptoms, and assist in bonding everything together into a comprehensive treatment plan.

You Don’t Have to Suffer in Silence

Functional GI disorders are real, so your quality of life could be considerable and treatment can be found. If you are dealing with bloating, constipation, diarrhea or gut pain daily, please note it isn't "in your head".  It is a condition worthy of investigative effort by a medical expert. 

At GEM Hospital, our team of experienced gastroenterologists are knowledgeable in the aspects of functional GI disorders. We offer various diagnostic options while maintaining dedicated essential member individual care. In other words, you can live symptom free! 

Control your gut health today!  Book your appointment today at GEM Hospital, allow us to help you guide through a better life!