In gastroenterology clinics, it is common to see patients with significant gastrointestinal symptoms, such as nausea, vomiting, belching, abdominal pain, bloating, diarrhea, and constipation, who have been seen several times and who cannot be found to explain the abnormal clinical presentation after multiple examinations. These were previously regarded as so-called neurological disorders, but in recent years they are considered to be functional gastrointestinal disorders. Functional gastrointestinal disorders, also known as gastrointestinal dysfunction or functional digestive disorders, account for approximately 50% to 70% of patients seen in gastroenterology outpatient clinics. Some of these patients are correctly diagnosed and treated, while a significant portion may be diagnosed by inexperienced physicians as chronic gastritis, chronic enteritis, etc., causing patients to take long-term medication and unnecessary financial losses. What is functional gastrointestinal disease Functional gastrointestinal disease is a general term for a group of gastrointestinal syndromes, mainly gastrointestinal tract dysfunction, mostly accompanied by psychiatric factors such as insomnia, anxiety, depression and other background. After excluding the organic causes, there are different names according to the symptom characteristics. Those with symptoms dominated by esophageal symptoms are common in gastroesophageal reflux disease, those with symptoms dominated by upper gastrointestinal tract are common in functional dyspepsia, and those with symptoms dominated by lower gastrointestinal tract are common in irritable bowel syndrome. Because the GI tract is a complete system, symptoms can often overlap between different diseases. What are the characteristics of functional gastrointestinal disease? The common characteristics of functional gastrointestinal disease are: long duration of illness, usually should last for several months or even years; slow onset, intermittent episodes, often with remission period, i.e. symptoms are sometimes mild, sometimes severe, sometimes good, sometimes bad; patient’s symptoms have variability, i.e. the same disease, different individuals can have different manifestations; often excessive mental tension, family disputes, difficulties in life and work, etc.; often accompanied by palpitations, shortness of breath, chest tightness, redness, insomnia, anxiety, inattentiveness, forgetfulness, hypersensitivity, sweaty hands and feet, polyuria, headache and other manifestations of plant nervous imbalance. How to diagnose functional gastrointestinal diseases The diagnosis of gastrointestinal diseases mainly includes imaging diagnosis, pathological diagnosis and functional diagnosis. Imaging diagnosis is made through lesions found by gastroscopy and gastrointestinal imaging, pathological diagnosis is made through cytological patterns of biopsies, and functional diagnosis is made through clinical manifestations. Functional gastrointestinal disease can only be diagnosed when organic diseases of the esophagus, gastroduodenum and colon (such as tumors, ulcers, etc.) are excluded and there is clearly no hepatobiliary-pancreatic or other organ lesions. After the appearance of abdominal discomfort, the doctor should first determine whether relevant examinations are needed and make it clear that there are no other pathologies before the diagnosis of functional gastrointestinal disease can be made. The Rome Working Group of the International Digestive Organization has developed and updated the diagnostic criteria for functional gastrointestinal diseases from Rome I to Rome IV since 1980. In particular, the concept of abnormal intestine-brain interaction was introduced in the Rome IV criteria, and detailed diagnostic criteria have been formulated for various functional gastrointestinal diseases. What are the causes of functional gastrointestinal disorders Functional gastrointestinal disorders are often closely related to movement disorders, visceral hypersensitivity, altered intestinal flora, and psychosocial-physiological factors. Genetic factors exist in some patients, and environment is also an important factor, such as heavy workload, increased financial burden, fierce competition at work, too fast pace of life, layoff and unemployment, death of relatives, stimulation from accidents, interpersonal tension and family disputes. Food factors such as sour fruits, spices, alcohol, chili peppers and strong coffee are also triggers of this disease. What are the common functional gastrointestinal diseases? Functional gastrointestinal diseases mainly include: functional heartburn, functional chest pain, hysteria, functional dyspepsia, irritable bowel syndrome, functional bloating, functional constipation, functional diarrhea and functional abdominal pain syndrome. Among them, gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome are the most common. Gastroesophageal reflux disease typically presents with heartburn and reflux. Heartburn is a burning sensation or pain that starts behind the sternum or in the upper abdomen and spreads all the way to the throat. Reflux is a feeling of stomach contents entering the esophagus and even the pharynx and mouth. Atypical symptoms include extraesophageal manifestations such as dry and itchy throat, bad taste in the mouth, hoarseness, chronic cough that is not cured for a long time, and chest pain that is easily misdiagnosed as heart disease. Functional dyspepsia The main symptoms include epigastric pain, epigastric distention, early satiety, belching, or epigastric discomfort such as burning pain, acidity, loss of appetite, nausea, vomiting, etc. The symptoms may persist or recur, and the duration of the disease is more than one month. Most of them have a slow onset, and the course of the disease often lasts for years and years, with persistent or recurrent episodes. These patients are often told that they have chronic gastritis on endoscopy, and more often than not, the diagnosis of chronic atrophic gastritis causes panic in patients. Patients often get the information that chronic atrophic gastritis is a precancerous disease from individual doctors or some popular science articles, and then they get worried and afraid. In fact, the above-mentioned gastric symptoms correlate poorly, if at all, with the endoscopic findings of chronic gastritis. Irritable bowel syndrome is a functional bowel disease characterized by persistent or indirect episodes of abdominal pain or discomfort, which may be relieved by defecation, accompanied by changes in bowel habits and stool properties without any organic disease that can explain the symptoms. The onset or exacerbation of symptoms is often related to dietary factors and rarely wakes up with pain during sleep. Others have to go to the toilet to defecate when they encounter something important or when they are emotionally excited, which is also a typical manifestation of irritable bowel syndrome and is related to emotions. Although this disease is not life-threatening, it can seriously affect the quality of life and should be taken seriously. How to treat functional gastrointestinal disease Since the occurrence of functional gastrointestinal disease is closely related to psycho-social-physiological factors, the correct treatment is: prevention of episodes as the main focus, supplemented by drug treatment, regulation of psychological state, improve lifestyle, correct the triggering factors. 1. Maintain a good psychological state. Eliminate unnecessary tension, worry, fear and other adverse psychological state, establish confidence to overcome the disease. Maintain optimism, broad-mindedness, emotional optimism, good mood, gastrointestinal function will be good. 2.Adopt a healthy lifestyle. Live a regular life, eat regularly, combine work and rest, and actively participate in physical exercise and recreational activities to distract attention. Avoid sedentary, standing, more aerobic exercise, exercise 3 to 5 times a week, each exercise for about 30 minutes. 3, pay attention to diet conditioning. Eat a light diet, eat more fresh vegetables and fruits, eat more coarse grains, drink more water, drink more yogurt. Avoid rough, greasy and stimulating food, avoid cold drinks, eat less and more meals, avoid tobacco, alcohol and coffee, etc. Avoid smoking and alcohol and taking non-steroidal anti-inflammatory drugs, and avoid foods that can induce symptoms in personal life experience. 4.Medication symptomatic treatment. For gastrointestinal motility disorders and gastrointestinal visceral hypersensitivity, drugs that regulate gastrointestinal motility and reduce gastrointestinal irritation factors can be used. Regulate gastrointestinal motility drugs are pro-gastrointestinal motility drugs gastrointestinal antispasmodics. Stimulation reducing drugs include commonly used are gastric acid inhibiting drugs, digestive enzyme preparations and intestinal probiotics. For patients with functional gastrointestinal disorders with significant depression and anxiety disorders can be supplemented with anti-anxiety and depression medications. In fact, medications, both prescription and over-the-counter, are recommended to be used under the guidance of a medical professional.