Abstract
BackgroundPatients with disorders of gut-brain interaction (DGBI) report meal intake to be associated with symptoms. DGBI patients with meal-related symptoms may have more severe symptoms overall and worse health outcomes, but this subgroup has not been well characterized. We aimed to describe the global prevalence of meal-related abdominal pain and characterize this subgroup.MethodsThe data analyzed originated from the Internet survey component of the population-based Rome Foundation Global Epidemiology Study, completed in 26 countries (n = 54,127). Adult subjects were asked whether they had abdominal pain and how often this was meal-related. Respondents were categorized into “no,” “occasional,” and “frequent” meal-related abdominal pain groups based on 0%, 10–40%, and ≥50% of the pain episodes being meal-related, respectively. DGBI diagnoses, frequency of other GI symptoms, psychological distress, non-GI somatic symptoms, quality of life, and healthcare utilization were compared between groups. Mixed linear and ordinal regression was used to assess independent associations between psychological distress, non-GI somatic symptoms, quality of life, other GI symptoms, and meal-related abdominal pain.ResultsOverall, 51.9% of the respondents reported abdominal pain in the last 3 months, and 11.0% belonged to the group with frequent meal-related abdominal pain, which included more females and younger subjects. DGBI diagnoses were more common in subjects with frequent meal-related abdominal pain, and the frequency of several GI symptoms was associated with having more frequent meal-related abdominal pain. Having meal-related abdominal pain more frequently was also associated with more severe psychological distress, non-GI somatic symptoms, and a poorer quality of life. The group with frequent meal-related abdominal pain also more often consulted a doctor for bowel problems compared to the other groups of meal-related abdominal pain.ConclusionReporting frequent meal-related abdominal pain is common across the globe and associated with other GI and non-GI somatic symptoms, psychological distress, healthcare utilization, and a poorer quality of life. Individuals who frequently experience meal-related abdominal pain also more frequently fulfill the diagnostic criteria for DGBI. Assessing meal-related symptoms in all DGBI patients could be of major importance to improve and individualize symptom management.
Highlights
Patients with disorders of gut-brain interaction (DGBI) report meal intake to be associated with symptoms
To characterize subjects with meal-related abdominal pain, we aimed to describe the association between the frequency of meal-related abdominal pain and other GI symptoms, DGBI diagnoses, psychological distress, quality of life, and healthcare utilization
Worldwide prevalence of frequent meal‐related abdominal pain As displayed in the flowchart, we found that 51.9% of the global population reported that they experienced abdominal pain and 48.1% never experienced abdominal pain in the last 3 months (Fig. 1)
Summary
Patients with disorders of gut-brain interaction (DGBI) report meal intake to be associated with symptoms. Disorders of gut-brain interaction (DGBI) are diagnosed by a typical gastrointestinal (GI) symptom pattern, in the absence of alarm features or evidence of organic disease processes that can account for the symptoms, and after a minimal relevant clinical evaluation [1]. It is logical that these disorders are one of the leading causes for consultations in primary care [3, 4]. They negatively influence the quality of life of patients and have a high impact on healthcare costs [5,6,7]. Food intolerance has been recognized as an important pathophysiological factor [8, 9]
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