Functional Bowel Disorders
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Introduction
Where no structural abnormality of the bowel microscopic or otherwise can be identified by conventional investigation, a patient who complains of one or other large bowel symptoms may be diagnosed with a functional bowel disorder. To be put plainly, there is failure of the gastrointestinal tract to transport ingested material from one end to the other and evacuate it without the patient experiencing some difficulty or discomfort at some or all stages of the process. This may be caused by a failure of the muscles and nerves involved in the process to work independently and efficiently or by the patients heightened awareness of the process itself.
These disorders are:
- Constipation
- Diarrhoea
- Irritable Bowel syndrome
- Incontinence
- Pelvic Floor/ Evacuatory disorders (Prolapse and Obstructed defaecation)
They are rarely experienced in isolation. Many patients who have functional bowel disorders experience symptoms identical to those who have recognised conditions of the large bowel such as bowel cancer, colitis or diverticular disease. There are no simple tests to diagnose such functional disorders and usually patients have to undergo invasive and unpleasant investigations that are usually reported as being “normal” to be certain that there is no danger to them. Despite the reassurance of these findings, symptoms that may dominate many people’s lives remain and are very real. The symptoms may exist in isolation or more often in clusters and are listed below.
- Change in bowel habit – Constipation and / or diarrhoea
- Rectal bleeding
- Mucus discharge
- Obstructed/ Incomplete evacuation of faeces
- Abdominal Pain
- Bloating
- Nausea
- Pelvic Pain
- Painful sexual intercourse