Disorders of gut-brain interaction (DGBI)

We care for young patients with the most handicapping symptoms, offer second opinions to other healthcare providers, and provide a wide range of diagnostic procedures when necessary.

Disorders of gut-brain interaction (DGBI), formerly referred to as pediatric functional gastrointestinal diseases (FGID), is an umbrella term that includes the very common irritable bowel syndrome (IBS). DGBI in children and adolescents is characterized by long-term, recurring gastrointestinal symptoms not caused by organic disease.

Young people with DGBI often have difficulty focusing in school and can also develop psychological issues as a result of all the handicapping symptoms. While the disorders can usually be diagnosed with a minimum of diagnostic procedures, it is common for children to undergo unnecessary examinations. At the same time, it is important not to miss diseases of pathologically decreased intestinal function. Differentiating between these diseases often requires an experienced pediatric gastroenterologist.

Disorders of gut-brain interaction can result in stomach pain, constipation, acid reflux, nausea, and vomiting. This can lead to many challenges for the child. Very intense symptoms can make it hard for the child to live a normal life and often affect the whole family.

It is common for children to have temporary problems of the gastrointestinal tract in the form of loose stools or transient mild stomach aches. In order for such problems to be classified as DGBI, the symptoms must be both recurrent and long-lasting, at least for a period of months.

Disorders of gut-brain interaction is not a diagnosis made by ruling out other causes, but a diagnosis made using strictly defined diagnostic criteria, including recurring symptoms over two months.

A thorough medical history, including the growth curve, physical examination, and in most cases, a limited blood sampling, are sufficient for a diagnosis to be made in most cases.

An important basis for successful treatment is to help the patient understand the underlying mechanisms behind the pain or the often handicapping symptoms. The relationship between the healthcare provider and the child thus becomes essential. It is also vital that discussion takes place in peace and quiet and that there is room to ask questions. The child's and their guardian's understanding of what the problems mean, along with the condition's often good prognosis, are in themselves a cornerstone of the treatment.

We always emphasize that the symptoms are real, that they are not imaginary. To calm the child and the parents and address common concerns about other illnesses, it is important to gain an understanding of how the gastrointestinal tract works, why the symptoms occur, and how they differentiate from other diseases. We can demonstrate this using instructive images. Increased understanding and decreased concerns can have a major effect on symptoms and experienced pain.

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Astrid Lindgren Children's Hospital

The Astrid Lindgren Children’s Hospital is a part of Karolinska University Hospital, with facilities in several locations in Stockholm.