The gut is in fact one long organ of digestion. It runs from the mouth to the anus and is approximately six metres in length. Although sections of it become specialised for different activities, it is essentially a hollow muscular tube. For effective digestion to occur, the gut must propel ingested material all the way along its length, and prevent excessive back flow throughout.
The gastro-intestinal (GI) organs are part of a very primitive system, and the first that organisms developed during evolution. The connections to and from it therefore are very intricate and variable, particularly those that link it to the nervous system and brain. The gut and brain in fact often act as a single highly complex unit (brain-gut-axis) and this also governs how sensitive we are, and hence how we respond to certain provocations.
The gut also contains billions of bacteria and other microscopic organisms. Many of these are essential to help us with our digestion, however too many of the wrong type, and problems can occur. We are beginning to increasingly realise how important this factor is the health of our GI system and hence our general health.
Sometimes, the function of the gut does not as work effectively as it can. Problems can arise, and the brain perceives some of these as symptoms. How bad these symptoms are depended on how affected the function is, and how the brain perceives the signals it receives.
Some distinct conditions with certain characteristics are defined as a specific disease such as reflux and certain motility disorders. In many cases, however there are a combination of problems which do not neatly fit into a disease category, but fit in somewhere along a wide spectrum of bowel disorder.
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There is an enormous range of symptoms which fit in with functional bowel disorder. Many overlaps with symptoms of common gastro-intestinal conditions including reflux, hiatus hernia, gallstones, ulcer disease and diverticular disease. Indeed, many of these conditions also exist on the background of functional bowel disorder, so it may be difficult to differentiate between them.
Laryngo-pharygneal reflux (LPR), sometime referred to as silent reflux is a complex condition where individuals are badly affected by symptoms which trouble the areas around their throat, back of the mouth and nose. This can cause a wide range of problems including hoarse voice, sore throat, chronic dry cough, nasal congestion, dental damage and strange sensations in the head and neck area.
In some cases, this can be due to acid reflux from the stomach, but in many this may be a more complicated situation with a combination of reflux, motility and functional elements. Very frequently, patients with LPR-type symptoms are poorly managed, and indeed some treatments can make their condition worse in the long term. It is important therefore if you have this kind of problem to get an accurate assessment of your situation so that management can be optimised.
Small intestinal bacterial overgrowth (SIBO) and changes in the bacteria normally residing in your gut (the gut microbiome), and important for many digestive functions can also cause problems with overlap with reflux and functional or motility disorders. Unfortunately, long-term use of certain drugs which are used to control reflux symptoms can make this worse, so again it is helpful to get an accurate and specialist assessment of your condition if you have troublesome symptoms or are dependent on medication.
Irritable bowel syndrome (IBS) is a certain type of functional bowel disorder. Some of the common symptoms include pain or discomfort in the chest, upper, middle or lower abdomen; bloating; heartburn; regurgitation; difficulty in swallowing; nausea; vomiting; diarrhoea or loose motions; constipation and problems with defecation. These can be very variable, and come and go, sometimes being extremely severe and sometimes not be there at all. Several symptoms can occur at the same time.
All sorts of factors may affect these symptoms including diet, activities, mood, stress, anxiety and general health. If symptoms deteriorate or are not well controlled, then this can have a profound and negative detrimental impact of quality of life and wellbeing. Functional bowel disorders may also affect other body systems (e.g. respiratory, immune) and result in nutritional deficiencies and psychological problems.
