Medical symptoms or conditions in which no anatomical abnormalities are found are labeled functional disorders. Functional bowel disease involves the gastrointestinal system, usually the mid or lower digestive tract, and is also known as irritable bowel syndrome, spastic bowel or spastic colon. The lack of pathologic findings in the gut, as well as the multiple descriptions for the same disorder, have made functional bowel disease difficult to study, though more vigorous diagnostic criteria has allowed a more elaborate scientific description of the disorder.
Features
The underlying disorder of functional bowel disease appears to be either too forceful or too few contractions of the colon for unknown reasons. The disorder usually begins in the third decade of life, reports FamilyDoctor.org, and is rarely is seen in the elderly. More women than men are affected by the disorder. Stress can exacerbate the condition, as well.
Symptoms
The American College of Gastroenterology lists several classic symptoms of functional bowel disorders, including bloating with gas, diarrhea or constipation, urgency and feeling of incomplete emptying after defecation, as well as mucus in the stool. Abdominal discomfort and cramping are usually prominent features, often relieved by defecation. In some people, the symptoms of functional bowel disease are so severe that they restrict activities of daily living.
Types
According to the American Society of Colon and Rectal Surgeons, functional bowel disorders are divided into three main types based on which symptoms predominate. Diarrhea-predominant functional bowel disease is characterized by three or more loose, watery stools a day accompanied by urgency. Constipation-predominant disease is present when three or less stools, usually hard and lumpy, are produced a week. A third type is one in which abdominal pain and discomfort is present, usually relieved with defecation, though without routine diarrhea or constipation.
Diagnosis
Functional bowel disease is usually not associated with any abnormal laboratory or diagnostic tests, thus the diagnosis has to be made by exclusion. When typical symptoms are present and other gastrointestinal abnormalities are ruled out, functional bowel disease is the likely diagnosis. The American College of Gastroenterology lists the usual workup for a functional bowel disorder to be laboratory tests such as a complete blood count, erythrocyte sedimentation rate, and chemistries and examination of the stool for white blood cells, blood and infectious agents. An elevated erythrocyte sedimentation rate, presence of anemia or blood in the stool suggest a cause other than functional bowel disease. Other tests often performed are sigmoidoscopy, colonoscopy or a barium enema to visualize the inside of the colon.
Treatment
Treatment of functional bowel disease begins with lifestyle changes such as eating frequent small meals, drinking plenty of water and finding healthy ways of dealing with stress, according to FamilyDoctor.org. Eliminating fats and sugars such as fructose from the diet may help with symptoms of bloating and gas. Depending on the predominant symptoms, drugs may be utilized, including laxatives, bulking agents, antidiarrhea drugs, tricyclic antidepressants, calcium channel blockers or 5HT3 receptor antagonists. Antispasm and anti-anxiety medications may be useful. Treatment of functional bowel disease is most effective when coordinated with a health care provider familiar with the disorder and the various therapeutic options.
