Functional Gastrointestinal Disorder

A 27-year-old female presents with a 3-month history of bloating and abdominal discomfort that occurs almost daily. She reports frequent flatulence and belching, particularly after meals. Her bowel habits have been regular, with no significant changes in frequency or consistency. She has no weight loss or other systemic symptoms. She has a high-stress job and mentions that her symptoms seem to worsen during stressful periods. She is currently avoiding carbonated beverages but has not tried any dietary changes.

Physical Exam Findings:

• General: Healthy-appearing female
• Abdomen: Mild tenderness in the epigastric region but no distension
• Rectal exam: Normal, no blood or abnormalities

Initial Investigations:

• CBC: Normal
• CRP: Normal
• Lactose breath test: Negative
• Diagnosis of functional gastrointestinal disorder (possibly functional dyspepsia) is suspected.

MCQs:

1. Which dietary change is most likely to help alleviate this patient's symptoms?
   • A) Increase fiber intake
   • B) Eliminate FODMAPs
   • C) Reduce fat intake
   • D) Avoid caffeine
2. What pharmacological treatment could be considered for bloating and discomfort?
   • A) Proton pump inhibitors
   • B) Simethicone
   • C) Loperamide
   • D) Rifaximin
3. Which lifestyle modification might benefit this patient?
   • A) Engage in regular physical activity
   • B) Increase daily calorie intake
   • C) Eliminate all carbohydrates
   • D) Start a high-protein diet

Answers with Explanations:

1. Answer: B) Eliminate FODMAPs
   Explanation: A low FODMAP diet can help reduce bloating and gas in patients with functional gastrointestinal disorders.
2. Answer: B) Simethicone
   Explanation: Simethicone can help relieve bloating and discomfort by reducing gas bubbles in the digestive tract.
3. Answer: A) Engage in regular physical activity
   Explanation: Regular physical activity can help improve gastrointestinal motility and reduce stress, both of which may alleviate symptoms.

Overview of the Topic: Functional Gastrointestinal Disorder
Functional gastrointestinal disorders include conditions where patients experience symptoms without an identifiable organic cause. Management typically involves dietary changes (such as the low FODMAP diet), lifestyle modifications, and pharmacological treatments aimed at symptom relief.

Key Learning Points:

• Functional gastrointestinal disorders can present with symptoms like bloating and discomfort without identifiable pathology.
• Dietary changes and stress management are crucial components of management.
• Simethicone can be effective in alleviating gas-related symptoms.