Main Symptoms of Functional Gastrointestinal Disorders
Functional gastrointestinal disorders (FGIDs) are symptom-based conditions without structural or biochemical abnormalities sufficient to explain the complaints. They involve any gut segment from esophagus to anus, often overlap, and fluctuate with diet, stress, and hormonal cycles. Recognising the dominant symptom pattern guides targeted evaluation and avoids unnecessary testing.
- Esophageal cluster
- Heartburn and regurgitation: burning retrosternal rise of acid or bitter fluid, worse after large meals or recumbency.
- Globus sensation: persistent lump or tightness in the throat between swallows, not during eating.
- Chest pain: midline squeezing or stabbing, sometimes indistinguishable from cardiac origin.
- Gastro-duodenal cluster
- Post-prandial fullness: heavy, bloated feeling that starts soon after eating and may last hours.
- Early satiation: unable to finish a normal-size meal.
- Epigastric pain or burning: vague soreness localized between costal margins, not consistently relieved by acid suppression.
- Bowel cluster
- Abdominal pain: crampy, diffuse or localized, often relieved by defecation.
- Altered stool form: hard or lumpy (constipation), loose or watery (diarrhea), or alternating between the two.
- Bloating and visible distension: waistband tightens despite unchanged weight.
- Urgency and tenesmus: compelling need to defecate with incomplete evacuation.
- Anorectal cluster
- Difficult evacuation: straining, sensation of blockage, or need for digital assistance.
- Pelvic heaviness or prolapse awareness during stool passage.
- Associated extras
Fatigue, non-restorative sleep, headache, low-back pain, and heightened worry about serious disease are common across all FGIDs.
Red-flag features that exclude FGIDs
Persistent vomiting, dysphagia, overt bleeding, unintentional weight loss >5 % in six months, iron-deficiency anaemia, fever, or palpable mass—these warrant prompt endoscopy or imaging.
Summary table
| Segment | Dominant symptom | Typical timing | First self-care step |
|---|---|---|---|
| Esophagus | Heartburn, globus | After meals, lying down | Elevate head, smaller meals |
| Stomach | Fullness, epigastric burn | During/after eating | Eat slowly, avoid fats |
| Bowel | Crampy pain, bloat | Variable, stress-linked | Fiber adjustment, walk |
| Rectum | Straining, urgency | At defecation | Footstool, pelvic floor relax |
| General | Fatigue, worry | Daily | Sleep hygiene, reassure |