Mo1303 Inflammation and Impaired Motility in Postoperative Ileus

Abstract

Background: Functional bowel disorders (FBDs) are common, impact on quality of life and are associated with significant healthcare costs. The occurrence of FBD symptoms has been linked to dietary intolerance; however the interaction between dietary, demographic, and psychosocial factors has not been assessed in adequately powered, population-based studies. Aims: To investigate the prevalence of FBDs in an Chinese population with lactase deficiency and the contribution of food intolerance (self-reported lactose intolerance (SLI) and lactose intake), psychological factors and stressful life events on FBDs. Methods: Adult subjects (16-74 years) selected at random from the community completed questionnaires detailing demographic information, gastrointestinal symptoms, consumption of lactose, psychological factors, life event stress and quality of life. FBDs were diagnosed by Rome III criteria. A logistic regression model was used to identify independent risk factors that increased the likelihood of subjects reporting FBD symptoms.Results: Complete responses were available from 1999/2115 (94.5%) subjects. 831 (41.6%) reported FBD symptoms. Among them the unspecified functional bowel disorder was the most prevalent (12.6%). The second was functional constipation (FC) (9.9%), the followed by functional bloating (FB)(6.8%),functional diarrhea(FD)(6.5%) and IBS (5.9%). More women than men had functional constipation (6.2% vs. 3.8%, p<0.001) and bloating (4.0% vs. 2.8%, p=0.038) but this was not found for functional diarrhea (3.0% vs. 3.5%) or irritable bowel syndrome (2.9% vs. 3.0%). FBDs reported food intolerance and specifically SLI more often than non-FBDs (28.8% vs. 16.0%, p<0.001) and consumed less lactose (p=0.019). FBD patients had a greater likelihood of depression or anxiety than non-FBDs (both, p<0.001), experienced more Life Event stress than non-FBDs (p<0.001) and reported lower quality of life (p<0.001). The joint effects of psychiatric morbidity, life event stress and lactose intake on the risk of FBDs are observed. In a logistic regression model, independent risk factors for FBDs included SLI (OR 1.81 (95%CI 1.44-2.27, p<0.001)), psychological illness (OR 1.46 (95% CI 1.19-1.81, p<0.001)) and recent life event stress (OR 1.28 (95%CI 1.06-1.55, p=0.009)). Conclusions: FBDs are common in China. Food intolerance, psychological factors and life event stress increase the likelihood of subjects in the general population reporting FBD symptoms. Table 1. The joint association of psychologic disease, life event stress, lactose intake with FBD among subjects.