Gastrointestinal Symptoms and Dietary Practices Among the United States (U.S.) Population: A National Survey

Abstract

Introduction: There is limited information regarding epidemiology of gastrointestinal (GI) conditions and dietary strategies among the United States (US) population. Methods: IRB-approved cross-sectional study using SurveyMonkey®. A 19 item survey regarding demographics, GI symptoms, treatments and dietary practices was administered in March 2017 to a representative US sample. Subjects were queried regarding: abdominal pain, diarrhea, constipation, gas/bloating, and heartburn symptoms, treatment strategies and food triggers. Among the listed foods, a high-FODMAP variable was created. Eligible subjects were men and women, aged 18 to 80. For analysis, GI symptoms noted ‘all/most’ of the time were ‘positive’, symptoms listed ’some/none’ of the time were ‘negative’. Logistic regression was performed to evaluate the impact of gender and age on GI symptoms. Results: 1881 subjects responded, 1718 (91%) were included. Of these, 47% were male and 53% were female. Subjects were evenly distributed by age, income, and region; 80% identified as white. Positive GI symptoms were noted by 45% overall. These included gas/bloating (26%), heartburn (17%), diarrhea (15%), abdominal pain (15%), and constipation (14%). Most common strategies to reduce GI symptoms included food avoidance (62%) and OTC remedies (47%); 16% cited prescriptions. Half of respondents deemed their treatment strategies effective ‘all/most’ of the time, 6% cited ‘never’. Most common food triggers were fried/greasy foods (51%), dairy (29%), beans (27%), and chili (27%). High-FODMAP foods were triggers among 63%. While 93% knew of gluten-free, 12% knew of low-FODMAP. The majority (69%) denied following dietary plans; 10% reported dairy-avoidance, 6% gluten-free and 2% low-FODMAP. Female gender and age under 45 years were associated with higher rates of abdominal pain, constipation and bloating in a logistic regression model (all p<0.05) Conclusion: GI symptoms impact up to 45% of individuals,with females and those under 45 noting a larger burden. Several strategies were utilized by the cohort, yet their effectiveness was modest. While numerous dietary triggers including high-FODMAP foods were identified, a minority reported following dietary plans. Outreach may improve awareness and enhance symptom control.