Abstract
BackgroundThe epidemiology of functional diarrhea and its impacts on Chinese remain unclear, and there are no data on the comparative epidemiology of functional diarrhea and diarrhea-predominant irritable bowel syndrome (IBS-D). This study was to explore the epidemiology of functional diarrhea and its impacts, and to identify its distinction from IBS-D.Methods and FindingsA cross-sectional survey was conducted in 16078 respondents, who were interviewed under a randomized stratified multi-stage sampling design in five cities of China. All respondents completed the modified Rome II questionnaire, and the 36-item Short Form health survey (SF-36) was used for assessing health-related quality of life in 20% of the sample. Overall, 248 respondents (1.54%) had functional diarrhea and 277 (1.72%) had IBS-D. Functional diarrhea was positively associated with increasing age and body mass index (trend test P<0.05). The three most common symptoms for at least 3 weeks in the past months were loose, mushy or watery stools (n = 203, 81.85%), more than three bowel movements a day (n = 100, 40.32%) and having to rush to the toilet to have a bowel movement (n = 72, 29.03%). Meaningful impairment was observed in 5 of the 8 SF-36 domains in respondents with functional diarrhea. The demographics are mostly similar between the respondents with functional diarrhea and IBS-D; however, respondents with IBS-D had more frequent symptoms of diarrhea and even lower scores in SF-36 domains than those with functional diarrhea.ConclusionsThe prevalence of functional diarrhea in China is substantially lower than that in Western countries and relatively higher than that in other Asian countries. It impaired health-related quality of life, and respondents with IBS-D have even worse quality of life. Further population-based studies are needed to investigate the epidemiology of functional diarrhea and the differences between functional diarrhea and IBS-D.
Highlights
Chronic diarrhea is a common illness in Western countries, such as Australia, Canada, Ireland, and the United States [1]
Further population-based studies are needed to investigate the epidemiology of functional diarrhea and the differences between functional diarrhea and irritable bowel syndrome (IBS-D)
Of the 16078 respondents, a total of 248 respondents (1.54%; 95% confidence intervals (CIs): 1.35–1.73%) were classified as having functional diarrhea according to the Rome II criteria
Summary
Chronic diarrhea is a common illness in Western countries, such as Australia, Canada, Ireland, and the United States [1]. It was reported that chronic diarrhea or loose or watery stools affected up to 26.9% of adults in the United States [2]. [3] Available evidence indicated that chronic diarrhea represents a significant health care burden in the United States [3]. Medical help is usually sought when diarrhea is more severe, is accompanied by fever or rectal bleeding, or results in prostration [4]. All these factors mean that chronic diarrhea is a major public health issue. This study was to explore the epidemiology of functional diarrhea and its impacts, and to identify its distinction from IBS-D
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