Functional Gastrointestinal Disorders
A 37-year-old female frequently complains of excess gas in the gut. A detailed history reveals that her complaints refer to abdominal bloating and fullness. When specifically questioned, she admits straining at stools and sensation of difficult gas evacuation, without excessive flatulence or belching.
A 58-year-old woman presents with over 25 years of constipation she defines as the urge to expel a bowel movement but the inability to evacuate satisfactorily. She strains excessively at hard stools and occasionally uses her finger to assist rectal emptying. Following a negative colonoscopy, she was instructed to use fiber supplements and various laxative preparations, but she has experienced minimal improvement.