Abstract
Objectives:Comparison of comorbidity and healthcare consumption in primary healthcare subjects with persistent functional gastrointestinal disorder (FGID) and a strictly gastrointestinal (GI) symptom-free group (SSF).Methods:A stratified sample (n = 1428, 21–86 years) of subjects living in the Östhammar community, Sweden, was limited to half of the community and classified through the Abdominal Symptom Questionnaire (ASQ) into two study groups, one with persistent FGID (n = 71), another SSF (n = 48). Symptoms were re-evaluated by means of the ASQ at a surgery visit, as was healthcare consumption during 2 years, and the levels of anxiety and depression, as measured with the Hospital Anxiety and Depression Scale. Diagnoses were set according to The International Classification of Diseases (ICD)-9 and the 14 diagnostic groups.Results:Of the FGID patients, 97% had a non-GI diagnosis, compared with 100% of SSF (ns). The mean number of doctors’ consultations (OR = 3.5), phone calls to doctors (OR = 3.4), number of prescriptions (OR = 2.4) and number of set diagnoses (OR = 3.9), anxiety level (OR = 11.5) and depression (OR = 5.2) were all statistically significantly higher (p < 0.05) for FGID than for SSF, while the number of referrals and sick leave were not. Besides a GI diagnosis, there was no significant difference (p > 0.05) in the spectrum of morbidity in terms of ICD-9 subgroup classification, except an increased proportion of older SSF subjects with circulatory disorders and hypertension.Conclusions:Functional gastrointestinal disorders are related to an increased demand on primary healthcare because of an increased overall comorbidity, which signifies a need for a holistic healthcare approach.
Highlights
Gastrointestinal (GI) symptoms are common, and in Sweden and other Western countries (1–3) have an estimated prevalence of 50% for dyspepsia, irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) together
The absence of GI complaints appear stable over time (3,8): a symptom survey conducted in Sweden over 7 years determined that from subjects who were symptom free at the beginning only 3% developed functional gastrointestinal disorders (FGID) and 3% reflux disease after 1 year, and this increased to 5% in each group after 7 years (8)
Comorbidity The FGID patients had a non-GI diagnosis code recorded in a majority, 97%, of the consultations, compared with a non-GI diagnosis code in all consultations among strictly gastrointestinal (GI) symptom-free group (SSF) patients
Summary
Gastrointestinal (GI) symptoms are common, and in Sweden and other Western countries (1–3) have an estimated prevalence of 50% for dyspepsia, irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) together. Many sufferers report more than one of the disorders concomitantly (4). The absence of GI complaints appear stable over time (3,8): a symptom survey conducted in Sweden over 7 years determined that from subjects who were symptom free at the beginning only 3% developed functional gastrointestinal disorders (FGID) and 3% reflux disease after 1 year, and this increased to 5% in each group after 7 years (8). Community surveys state that less than half of GERD or dyspepsia sufferers ever consult (1,3), whereas, those with IBS appear to initiate consultation more frequently (3). FGID account for one of 20 visits in primary care (1,9,10)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
