Functional gastrointestinal (GI) disorders, also called disorders of gut-brain interaction (DGBI), are a common group of conditions that can cause various symptoms, including abdominal pain, bloating, constipation, and diarrhea. These symptoms can significantly impact a patient’s quality of life, and effective diagnosis and treatment require a multidisciplinary approach.
The first step in diagnosing a functional GI disorder is to obtain a thorough medical history and conduct a physical exam. Diagnostic tests, including hydrogen and methane breath tests, blood tests, stool tests, or imaging studies, may be ordered depending on the patient’s symptoms.
Once confirming a diagnosis, a multidisciplinary team can work together to develop an individualized treatment plan. This team may include a gastroenterologist, a dietitian, and a mental health professional.
- Gastroenterologists play a key role in diagnosing and managing functional GI disorders. They may recommend antacids, laxatives, or anti-diarrheal agents to manage symptoms. Prescription antibiotics like rifaximin may also be necessary for some functional GI disorders like small intestinal bacterial overgrowth (SIBO). In some cases, they may also recommend procedures such as endoscopy or colonoscopy to evaluate the condition further.
- Dietitians can help patients make dietary changes that can improve symptoms. For example, patients with irritable bowel syndrome (IBS) may benefit from a low-FODMAP diet, which restricts certain carbohydrates that can trigger symptoms. For instance, patients with lactose malabsorption or intolerance may benefit from avoiding dairy products or taking lactase supplements.
- Mental health professionals can help patients manage their psychological and emotional symptoms since functional GI disorders can be stressful and lead to anxiety or depression. Cognitive-behavioral therapy (CBT) effectively manages symptoms of IBS and may also benefit other functional GI disorders.
Primary care physicians, integrative medicine practitioners, naturopaths, and other allied health professionals may also play a critical role in the multidisciplinary approach to diagnosing and treating functional GI patients.
- Primary care physicians are often the first point of contact for patients with GI symptoms and can be the fronline to SIBO diagnosis. They can conduct initial assessments, order preliminary tests, and make referrals to gastroenterologists or other specialists as needed. They can also work with dietitians and mental health professionals to develop an overall management plan for the patient.
- Integrative medicine practitioners combine conventional Western medicine with complementary and alternative therapies, such as acupuncture, massage, herbal remedies, and mind-body techniques like meditation or yoga, to help manage symptoms and improve overall health. Integrative medicine practitioners also can order diagnostic tests and address underlying factors contributing to the condition, such as stress, diet, or environmental factors.
- Naturopaths are licensed healthcare professionals focusing on natural therapies and treatments to support the body’s innate ability to heal. Naturopaths can order diagnostic tests for SIBO like CDI’s SIBO 10 Tube Glucose Breath Test, and identify and address underlying causes of functional GI symptoms, such as food sensitivities, nutrient deficiencies, or chronic stress. They may use a variety of treatments, such as herbal remedies, dietary supplements, acupuncture, and other holistic approaches to help manage symptoms and improve overall health.
- Other allied health professionals, such as nurse practitioners, physician assistants, and pharmacists, can also play essential roles in the multidisciplinary team. Nurse practitioners and physician assistants can conduct initial assessments and manage the patient’s condition. Pharmacists can help manage medication regimens and provide education on potential side effects and drug interactions.
Functional GI disorders can be challenging to diagnose and manage, but a multidisciplinary approach can improve patient outcomes and reduce the risk of complications or adverse events. A multidisciplinary team can collaborate to provide comprehensive, coordinated care, an individualized treatment plan for the underlying condition, and the patient’s unique needs and preferences. With the right approach, patients can relieve their symptoms and improve their quality of life.