Burden of functional gastrointestinal disorders in a surgical clinic in Sri Lanka

Introduction: Making a positive diagnosis of functional gastrointestinal disorders based on the patterns of symptoms allows the clinician to manage the patients without further investigations (treat and test strategy) to exclude an organic disorder (test and treat strategy). The objectives were to diagnose and classify the functional gastrointestinal disorders according to Rome III criteria among the patients attending to a Gastrointestinal surgery clinic and to assess the effectiveness of the treat and test strategy. Methodology: In a prospective study data were collected from consecutive patients who were likely to have functional gastrointestinal disorders. Diagnosis and classification were performed by an interviewer administered Rome III questionnaire. They were then treated according to their symptoms and considered for further investigations or only follow up depending on the response. Results: There were 103 patients with “likely FGID” among 665 clinic patients (15.4%) over six-month period. Eighty-two patients fulfilled the Rome III criteria (79.6 %). Forty-nine patients had single FGID (59.7%) whereas 33(40.2%) patients had overlap symptoms. Eighty-one patients (78.6 %) have been followed up for a mean duration of 12.3 months. Sixty-five patients (80.2 %) underwent investigations whereas sixteen patients had only followed up (19.8 %). Three patients (3.7 %) were diagnosed with organic illness during the follow up. Conclusion: Functional gastrointestinal disorders are common among our patients. Making a positive diagnosis initially can avoid unnecessary investigations. Close follow up is necessary to avoid false negatives if empirical treatment (algorithmic approach) is used in the initial management.