Evaluation of Lower Functional Gut Disorders

There is an element of the art of medicine in the diagnosis of functional lower gut disorders. Functional disorders are believed to be problems of normal gut function; by definition, they imply or require a lack of organic disease. With advanced understanding and reliable definitions of irritable bowel syndrome (IBS) in particular, the concept that these disorders are purely a diagnosis of exclusion is outdated. Their cardinal symptoms, however, such as abdominal pain, diarrhea or constipation, have huge lists of potential organic causes. The key is to know how much investigation is needed before making the diagnosis. Many factors will influence this process, from both the patient and practitioner viewpoints.