The 2 Types of Digestive Disorders
Summary:
There are two main types of GI disorders.
The 1st are called structural or organic disorders/diseases. Examples include
Gastroesophageal reflux disease (GERD)
Crohn’s Disease
Ulcerative Colitis
Ulcers
Diverticulitis
Cancer
These are disorders where a doctor can use a procedure like an upper endoscopy or a colonoscopy, they can take biopsies or use another of the range of tests, scans or scopes & be able to see the evidence of the disorder or disease in the GI tract. These often involve inflammation.
The 2nd type are often referred to as functional GI disorders. These are the most common GI disorders. For these disorders when testing is done (endoscopy, colonoscopy, blood tests) the doctor comes back & says “nothing is found”. What this means is that the symptoms are not due to inflammation, structural issues in the organs or cancer. It does not mean it’s “all in your head” or that it’s “just anxiety”. The most common types are
IBS
functional dyspepsia (indigestion)
functional heartburn (heartburn not due to GERD)
functional dysphagia (difficulty swallowing)
chronic nausea vomiting syndrome (CNVS).
There’s an overlap between structural & functional disorders. Many people with the 1st type (like Ulcerative Colitis or Crohn’s Disease) can also have a functional disorder as well (like IBS).
There have been medical advances in the understanding of functional disorders which has led to a change in the name, they are now referred to as Disorders of the Gut-Brain Interaction (DGBI). It’s a mouth full but it more accurately describes what’s going on below the surface of the symptoms - the gut-brain connection has become dysregulated.
DGBIs are the most common type but because they can’t be validated by any scope or test currently it’s easy to fall victim to the all too common idea that ‘it’s all in my head’ or that it’s ‘just anxiety’. This is not true. These are real disorders & there are effective treatments that can help if you educate yourself & advocate for yourself.
Chronic GI disorders can be messy, confusing & difficult to get under control. Getting clear on which type of disorder you have is essential. Effective stress management targeted to your specific symptoms is an important part of the puzzle but it’s only effective as a compliment when the other pieces, like effective medical care, are in order first. Knowing what type of disorder & how severe it is helps to create a priority list of when these skills should be addressed & when other treatments need to come first.
If you have a structural disorder you can explore whether you might also have a DGBI overlapping. This could help explain symptoms & also help you know when to prioritize different tools.
Selected Resources:
The Rome Foundation Video Library
Whether you have a structural disorder or a DGBI it’s useful to understand to main concepts & resources for DGBIs. The Rome Foundation is a great place to start.
The Rome Foundation Video Library is from the leading medical institution on DGBIs. If you have a DGBI there’s a good chance there will be useful info in here for you to learn about from a pioneer & expert Dr. Drossman. Dr. Drossman trains other doctors on how to treat DGBIs & have better, more helpful interactions with doctors that are not trained in the biopsychosocial model of GI health. So some of these resources are for patients & some are for doctors.
UNC Center for Functional GI & Motility Disorders Resources