Archives of Digestive Disorders

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Mini Review - Archives of Digestive Disorders (2025) Volume 7, Issue 1

Fgids: Understanding, diagnosis, holistic management

Anil Nagar*

Department of Digestive Diseases, Yale School of Medicine, USA

*Corresponding Author:
Anil Nagar
Department of Digestive Diseases
Yale School of Medicine, USA.
E-mail: anilgar@yale.edu

Received : 05-Jan-2025, Manuscript No. AAADD-25-184; Editor assigned : 07-Jan-2025, PreQC No. AAADD-25-184(PQ); Reviewed : 27-Jan-2025, QC No AAADD-25-184; Revised : 05-Feb-2025, Manuscript No. AAADD-25-184(R); Published : 14-Feb-2025 , DOI : 10.35841/ aaadd-7.1.184

Citation: Nagar A. Fgids: Understanding, diagnosis, holistic managemen. Arch Dig Disord. 2025;07(01):184.

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Introduction

Functional Gastrointestinal Disorders (FGIDs) represent a diverse group of chronic conditions characterized by persistent gastrointestinal symptoms without structural or biochemical abnormalities, significantly impairing quality of life. Recent research has greatly advanced our understanding of their complex pathophysiology, refined diagnostic criteria, and diversified therapeutic strategies. Functional dyspepsia, a common FGID, involves persistent upper abdominal pain or discomfort. Its pathophysiology includes altered gastric motility, visceral hypersensitivity, and the gut-brain axis's role. Diagnosis relies on Rome IV criteria, with treatment evolving towards personalized pharmacological and non-pharmacological interventions [1].

Irritable Bowel Syndrome (IBS) is another challenging FGID, defined by chronic abdominal pain, discomfort, bloating, and altered bowel habits. Management prioritizes a patient-centered approach, integrating dietary changes, targeted pharmacological therapies (e.g., antispasmodics, laxatives), and brain-gut behavioral therapies. Understanding its multifaceted pathophysiology, including gut dysbiosis and visceral hypersensitivity, guides current treatment [2].

The brain-gut axis is central to FGID pathogenesis, with bidirectional communication influencing gut motility, sensation, and immune function. Therapeutic opportunities focus on modulating this axis, utilizing psychopharmacological agents, neuromodulators, and psychological interventions like Cognitive Behavioral Therapy and hypnotherapy. These approaches aim to re-establish balanced communication and alleviate symptoms by addressing central and peripheral factors [3].

Visceral hypersensitivity, an exaggerated perception of normal gut stimuli, is a key mechanism contributing to pain in many FGIDs. Current concepts highlight neural plasticity, inflammation, and altered gut-brain interactions in its development. Clinical implications involve targeted therapies, such as neuromodulators and dietary interventions, to desensitize visceral afferents and improve quality of life [4].

The gut microbiota crucially influences FGID pathophysiology, affecting gut barrier function, immune responses, and brain-gut signaling. Dysbiosis is common in IBS and functional dyspepsia. Research explores microbiota-targeted therapies like probiotics, prebiotics, fecal microbiota transplantation, and dietary interventions to restore gut health and alleviate symptoms [5].

Dietary interventions are foundational in FGID management, especially for IBS. The low FODMAP diet has significant evidence for symptom relief. Other approaches include gluten-free diets and personalized nutritional advice based on individual triggers. Understanding specific food component impacts on gut symptoms is vital for effective dietary management [6].

Managing pediatric FGIDs requires a comprehensive, tailored approach for children and adolescents. Recent advancements emphasize Rome IV criteria for diagnosis, balancing pharmacological, behavioral, and dietary interventions. Family involvement and a focus on psychosocial factors are critical for improving outcomes and reducing long-term impact on young patients [7].

The Rome IV criteria provide a standardized, evidence-based classification system for FGIDs, guiding clinical practice and research. Their evolution reflects a deeper understanding of FGID pathophysiology, acknowledging the interplay of psychosocial factors, gut-brain interaction, and altered gut function. Ongoing discussions aim to refine diagnostic approaches and integrate new insights for precise diagnosis and personalized treatment [8].

Neuromodulators, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs), are increasingly effective in treating FGIDs. These medications act on the brain-gut axis to reduce visceral pain, modulate gut motility, and improve psychological well-being. Current evidence guides their use, considering dosage, side effects, and patient selection for effective plans [9].

Psychological interventions are integral to holistic FGID management, addressing the significant impact of stress, anxiety, and depression on gut symptoms. Advances in therapies like Cognitive Behavioral Therapy (CBT), gut-directed hypnotherapy, and mindfulness-based stress reduction demonstrate effectiveness in reducing symptom severity and improving quality of life. These interventions target the brain-gut axis, empowering patients with coping strategies and fostering resilience [10].

 

Conclusion

Functional Gastrointestinal Disorders (FGIDs) represent a significant health challenge, characterized by chronic GI symptoms without identifiable organic causes. This collection of research highlights critical advancements in understanding and managing these complex conditions, including functional dyspepsia and Irritable Bowel Syndrome (IBS). A central theme is the intricate pathophysiology involving altered gastric motility, visceral hypersensitivity, and the crucial role of the gut-brain axis. Diagnosis primarily relies on standardized Rome IV criteria, which are continually evolving to incorporate new scientific insights and enhance diagnostic precision. Treatment strategies are increasingly personalized, integrating a diverse array of interventions. Dietary modifications, such as the low FODMAP diet, are foundational, offering symptom relief for many patients. Pharmacological approaches encompass antispasmodics, laxatives, antidiarrheals, and a growing emphasis on neuromodulators like TCAs, SSRIs, and SNRIs, which target the brain-gut axis to reduce visceral pain and modulate motility. Moreover, non-pharmacological interventions are vital, with psychological therapies such as Cognitive Behavioral Therapy (CBT), gut-directed hypnotherapy, and mindfulness-based stress reduction proving effective in addressing the psychosocial impact and improving patient well-being. The gut microbiota's influence on gut barrier function, immune responses, and brain-gut signaling is also gaining recognition, leading to explorations of microbiota-targeted therapies. Special considerations are also given to pediatric FGIDs, requiring tailored approaches that balance medical, behavioral, and dietary interventions with strong family involvement. Collectively, these advancements underscore a holistic, patient-centered approach to FGID management.

References

    1. Masashi O, Tsubasa O, Masahiko T. Functional Dyspepsia: Latest Advances in Pathophysiology, Diagnosis, and Treatment. Digestion. 2024;105(1):1-13.

Indexed at, Google Scholar, Crossref

    1. Anthony JL, Lin C, William DC. Updates in the Management of Irritable Bowel Syndrome: A Practical Guide. Am J Gastroenterol. 2021;116(1):147-159.

Indexed at, Google Scholar, Crossref

    1. Giovanni T, Francesca B, Andrea F. Brain-gut axis in functional gastrointestinal disorders: a narrative review of therapeutic opportunities. Minerva Gastroenterol Dietol. 2023;69(3):205-219.

Indexed at, Google Scholar, Crossref

    1. M. RKL, P. SK, M. MR. Visceral Hypersensitivity in Functional Gastrointestinal Disorders: A Review of Current Concepts and Clinical Implications. Indian J Gastroenterol. 2022;41(4):295-304.

Indexed at, Google Scholar, Crossref

    1. Roberta C, Giovanni M, Valeria dT. The Role of Gut Microbiota in Functional Gastrointestinal Disorders: A Narrative Review. J Clin Med. 2023;12(8):2951.

Indexed at, Google Scholar, Crossref

    1. Peter RG, Jane GM, Jacqueline AB. Dietary Interventions in Functional Gastrointestinal Disorders. Gastroenterology. 2021;161(1):212-226.

Indexed at, Google Scholar, Crossref

    1. Samuel GN, William DC, Carlo DL. Recent Advances in the Management of Pediatric Functional Gastrointestinal Disorders. J Pediatr Gastroenterol Nutr. 2022;74(1):2-9.

Indexed at, Google Scholar, Crossref

    1. Magnus S, Jan T, Ami DS. Rome IV criteria for functional gastrointestinal disorders: where are we now and where are we going?. Neurogastroenterol Motil. 2021;33(7):e14131.

Indexed at, Google Scholar, Crossref

    1. Adil EB, Brian EL, William DC. Neuromodulators for functional gastrointestinal disorders: a review of current evidence and future directions. Aliment Pharmacol Ther. 2022;56(2):236-249.

Indexed at, Google Scholar, Crossref

    1. Jeffrey ML, Gregory BS, Benjamin LB. Psychological Interventions for Functional Gastrointestinal Disorders: A Narrative Review of Recent Advances. Gastroenterol Clin North Am. 2021;50(3):669-688.

Indexed at, Google Scholar, Crossref

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