Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life.

Adult Brain Female Gastrointestinal Diseases / diagnosis Humans Irritable Bowel Syndrome / diagnosis Male Quality of Life Rome Severity of Illness Index Surveys and Questionnaires
DGBI Epidemiology Functional Disorders Overlap Psychosocial

Journal

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775

Informations de publication

Date de publication:
05 2022
Historique:
received: 01 02 2021
revised: 07 04 2021
accepted: 21 05 2021
pubmed: 31 5 2021
medline: 20 4 2022
entrez: 30 5 2021
Statut: ppublish

Résumé

Conditions such as irritable bowel syndrome (IBS), functional dyspepsia, and functional constipation are among the prevalent gastrointestinal (GI) disorders classified as disorders of gut-brain interaction (DGBI), which can adversely affect the lives of sufferers. This study aimed to assess the degree and consequences of overlapping DGBI in a large population-based global scale. Internet survey data from 54,127 adults (49.1% women) in 26 countries were analyzed by 4 GI anatomic regions (esophageal, gastroduodenal, bowel, and anorectal). The number of DGBI-affected GI regions was assessed, including associations with sex, age, disease severity, quality of life, psychosocial variables, and health care utilization. A total of 40.3% of surveyed individuals met Rome IV criteria for a DGBI. The percentages with 1-4 DGBI-affected GI regions were 68.3%, 22.3%, 7.1%, and 2.3%, respectively. The IBS symptom severity score increased significantly from 1 (207.6) to 4 (291.6) regions, as did non-GI symptom reporting (somatization), anxiety and depression, concerns and embarrassment about bowel function, doctor visits, medications, and abdominal surgeries (all P < .0001). Quality of life decreased with increasing number of DGBI regions (P < .0001). In a logistic mixed model, non-GI symptoms (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.08-1.10), being very vs not concerned (OR, 2.55; 95% CI, 2.27-2.90), being very vs not embarrassed about bowel function (OR, 1.20; 95% CI, 1.08-1.33), and mean number of doctor visits (OR, 1.23; 95% CI, 1.115-1.32) were most strongly associated with number of DGBI regions. DGBI in multiple anatomic GI regions is associated with increased psychological comorbidity, health care utilization, and IBS severity. Physician awareness of overlap could improve quality of care, prevent unnecessary interventions, and yield more positive health outcomes.

Sections du résumé

BACKGROUND AND AIMS
Conditions such as irritable bowel syndrome (IBS), functional dyspepsia, and functional constipation are among the prevalent gastrointestinal (GI) disorders classified as disorders of gut-brain interaction (DGBI), which can adversely affect the lives of sufferers. This study aimed to assess the degree and consequences of overlapping DGBI in a large population-based global scale.
METHODS
Internet survey data from 54,127 adults (49.1% women) in 26 countries were analyzed by 4 GI anatomic regions (esophageal, gastroduodenal, bowel, and anorectal). The number of DGBI-affected GI regions was assessed, including associations with sex, age, disease severity, quality of life, psychosocial variables, and health care utilization.
RESULTS
A total of 40.3% of surveyed individuals met Rome IV criteria for a DGBI. The percentages with 1-4 DGBI-affected GI regions were 68.3%, 22.3%, 7.1%, and 2.3%, respectively. The IBS symptom severity score increased significantly from 1 (207.6) to 4 (291.6) regions, as did non-GI symptom reporting (somatization), anxiety and depression, concerns and embarrassment about bowel function, doctor visits, medications, and abdominal surgeries (all P < .0001). Quality of life decreased with increasing number of DGBI regions (P < .0001). In a logistic mixed model, non-GI symptoms (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.08-1.10), being very vs not concerned (OR, 2.55; 95% CI, 2.27-2.90), being very vs not embarrassed about bowel function (OR, 1.20; 95% CI, 1.08-1.33), and mean number of doctor visits (OR, 1.23; 95% CI, 1.115-1.32) were most strongly associated with number of DGBI regions.
CONCLUSIONS
DGBI in multiple anatomic GI regions is associated with increased psychological comorbidity, health care utilization, and IBS severity. Physician awareness of overlap could improve quality of care, prevent unnecessary interventions, and yield more positive health outcomes.

Identifiants

DOI: 10.1016/j.cgh.2021.05.042 PMID: 34052391
pubmed: 34052391
pii: S1542-3565(21)00580-2
doi: 10.1016/j.cgh.2021.05.042
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e945-e956

Informations de copyright

Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.

Auteurs

Ami D Sperber (AD)

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. Electronic address: amiroie@me.com.

Tamar Freud (T)

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Imran Aziz (I)

Academic Department of Gastroenterology & Department of Infection, Immunity and Cardiovascular Sciences, University of Sheffield, Sheffield, United Kingdom.

Olafur S Palsson (OS)

Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Douglas A Drossman (DA)

Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Education and Practice of Biopsychosocial Care, Drossman Gastroenterology, Chapel Hill, North Carolina.

Dan L Dumitrascu (DL)

Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Xuicai Fang (X)

Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Shin Fukudo (S)

Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Uday C Ghoshal (UC)

Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

John Kellow (J)

Discipline of Medicine, Northern Clinical School, University of Sydney, Sydney, Australia.

Rutaba Khatun (R)

Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Edith Okeke (E)

Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.

Eamonn M M Quigley (EMM)

Lynda K. and David M. Underwood Center for Digestive Disorders, Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas.

Max Schmulson (M)

Laboratory of Liver, Pancreas and Motility, Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico.

Magnus Simren (M)

Department of Clinal and Molecular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Jan Tack (J)

Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.

William E Whitehead (WE)

Center for Education and Practice of Biopsychosocial Care, Drossman Gastroenterology, Chapel Hill, North Carolina.

Peter Whorwell (P)

Neurogastroenterology Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom.

Shrikant I Bangdiwala (SI)

Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies du côlon › Troubles fonctionnels du côlon › Syndrome du côlon irritable › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › Qualité de vie › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Régions géographiques › Europe › Italie › Rome › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes de santé › Indicateurs d'état de santé › Acuité des besoins du patient › Indice de gravité de la maladie › Greater Overlap of Rome IV Disorders of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Greater Overlap of Rome IV Disorders of...