DGBI overlap: a model for a transdiagnostic approach?

Abstract

Disorders of gut–brain interaction (DGBI) are highly prevalent chronic gastrointestinal symptoms that are categorised into 33 disorders delineated by gastrointestinal anatomic region. 1 Drossman DA Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016; 150: 1262-1279 Summary Full Text Full Text PDF Google Scholar DGBI can occur in isolation, but frequently are present in combinations that affect multiple anatomic regions. The coexistence of multiple DBGI in an individual, termed overlap, has been linked to worse disease severity and quality of life. 2 Sperber AD Freud T Aziz I et al. Greater overlap of Rome IV disorders of gut–brain interactions leads to increased disease severity and poorer quality of life. Clin Gastroenterol Hepatol. 2022; 20: e945-e956 Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar However, the actual prevalence of DGBI overlap and associated features have remained unknown until Thomas Fairlie and colleagues 3 Fairlie T Shah A Talley NJ et al. Overlap of disorders of gut–brain interaction: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023; (published online May 18)https://doi.org/10.1016/S2468-1253(23)00102-4 Google Scholar conducted a systematic review and meta-analysis on the topic. Among 46 studies including 75 682 adults with DGBI, the authors found that over a third (n=24 424, pooled prevalence 36·5% [95% CI 30·7–42·6]) had DBGI overlap. 3 Fairlie T Shah A Talley NJ et al. Overlap of disorders of gut–brain interaction: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023; (published online May 18)https://doi.org/10.1016/S2468-1253(23)00102-4 Google Scholar Overlap occurred more frequently in participants recruited from tertiary health-care settings, suggesting worse gastrointestinal symptoms, and was associated with increased psychological symptom severity and lower quality of life scores. Taken together, the authors conclude that overlap is common and a feature of DGBI disease severity. Overlap of disorders of gut–brain interaction: a systematic review and meta-analysisOverlap of DGBI subtypes is frequent, and is more prevalent in tertiary care settings and associated with more severe symptom manifestations or psychological comorbidities. Despite the large sample size, the comparative analyses revealed substantial heterogeneity, and the results should be interpreted with caution. Full-Text PDF