When Form Doesn’t Function: Functional Gastrointestinal Disorders

Aug 5, 2020 | Rebecca Williams | @rjwilliams | Comments (6)

Architect Louis Sullivan coined the phrase “form follows function.” This became the battle cry of modernists in the early 1900’s against purely ornamental features of architecture. Decorative ornaments were considered superfluous. They believed that the design of an object should fit its intended purpose. The object should be functional. In the same way, there is an intended purpose for each organ of the digestive system.

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Each organ of the digestive system is formed to contribute to a person's overall function and digestive health. When one or more organ(s) appear(s) to be normal in form but is not functioning as it was intended, then acute and chronic symptoms can develop into what is known as functional gastrointestinal disorder (FGID). FGID can lead to continuous and/or recurring abdominal pain and other bothersome symptoms that have a negative impact on the quality of life for those who are affected. The most common FGID is irritable bowel syndrome (IBS) which can cause abdominal pain with either diarrhea, constipation, or both. Another FGID is nonulcer dyspepsia, or functional dyspepsia, which causes post-prandial upper gastrointestinal symptoms (mainly epigastric pain, belching, and nausea) that mimics a stomach ulcer.

The underlying cause of FGID can be multifactorial with the brain-gut interaction playing an important role. The concept of brain-gut interaction does not mean that FGID is imaginary. Symptoms of FGID are very real and have their basis in the neurological interaction of the brain and gut; however, for some there is a psychological element of FGID that can arise from past trauma and bereavement. Mayo Clinic gastroenterologist, Dr. Adil Bharucha explains,

“Cognitive behavioral therapy can help patients relax, provide a sense of control over symptoms, and induce more parasympathetic activity. Diaphragmatic breathing exercises can help patients reduce belching, regurgitation, and vomiting.”

At Mayo Clinic, the evaluation of FGID includes tests that can further phenotype the underlying functional disorder, thereby individualizing the treatment of FGID. General approaches to management and treatment of FGID can include adjustments in diet and other lifestyle strategies including:

  • Avoiding food that exacerbates symptoms. Though most people with FGID do not have a known food allergy, there are certain foods that trigger symptoms.
  • Soluble fiber supplements can offer a low cost effective treatment for those with IBS based on constipation.
  • Probiotics may be effective for those who symptoms include bloating and flatulence.
  • Investigating whether there is sensitivity to gluten or FODMAP’s. For those with symptoms that are not improving, it may be worth undergoing testing for celiac disease. Even if celiac disease is not present, there are those who are affected by non-celiac gluten sensitivity and may benefit from eliminating gluten from their diets. Those whose symptoms persist may consider working with their physician and a dietitian to explore the role of FODMAP’s. FODMAP’s are carbohydrates that are Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polys. Intestinal bacteria ferment these carbohydrates and produce gas and increased fluid.

The Healthy Living Program at the Mayo Clinic’s campus in Rochester, Minnesota offers patients an “immersive wellness experience” with individualized diet plans and exercise programs suitable for those with gastrointestinal disorders. This customized program is aimed at improving symptoms and the overall quality of life of those who participate in this program.

Dr. Donald Hensrud, medical director of the Healthy Living Program says,

“Many people realize their health would improve if they changed their diet plans and physical activity, but saying it and doing it are two different things. Similarly, most physicians see patients who would benefit from lifestyle changes but are not able to implement those changes on their own. In the Healthy Living Program, multidisciplinary teams of experts work one-on-one to design individualized wellness plans and provide ongoing support so participants’ success continues after they return home and are immersed in the realities of their busy lives.”

When form does not function as it was intended, patients should work with their physician to determine the treatment plan that best suits them. There are many pharmacological and lifestyle options to help them manage their condition.

Connect with other patients talking about FGID, digestive health issues, and more:  Digestive Health


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I've had ulcerative colitis for a few years, mild, but now I have an inability to deficate despite a sense of urgency. I cannot get in to see my gastroenterologist until January. He gave me a 3 week regimen of prednisone; it helped in the short-term, but I'm back to not being able to go. What can I do while I wait to see someone? I have lymphedema in both arms after a double mastectomy and this putting a painful strain on my arms and chest.


Hello @melanieshoffstall,

I would encourage you to join a conversation on Mayo Clinic Connect titled, "Ulcerative Colitis: What to do about constipation." You will read what others have tried. Here is the link to that conversation, https://connect.mayoclinic.org/discussion/ulcerative-colitis-2/.

If the pain is quite severe can you talk with an RN or a Physician's Assistant at your doctor's office for some help by phone?


Am having this kind of digestive problem for so long, have received some treatments but the situation remains the same, what can I do please


I am definitely no doctor, but maybe try changing your diet? I have found certain foods affect my digestive tract in different ways.


Am having this kind of digestive problem for so long, have received some treatments but the situation remains the same, what can I do please

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Welcome @masese. I encourage you to join the discussions in the Digestive Health group here: https://connect.mayoclinic.org/group/digestive-gastrointestinal-problems/


Recently diagnosed with colonic Inertia. Proposed removal of colon ( Tac IRA ) . But also have lost mobility in rectum. Failed 2 Manometry tests. Internal sphincter muscle doesn’t relax ? Ever ! Also proposed Botox treatment. I sure don’t want surgery only to still be in same condition. Recent gamma scan shows retrograde colon ? All very confusing, especially from someone who never experienced any gastrointestinal issues ever ! Would appreciate any advice or shared experience.

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