Risk Of Functional Gastrointestinal Disorders Research Articles

Relationships between emotional states, bipolar disorder, and gastrointestinal disorders: A two-sample Mendelian randomization study

BackgroundFunctional gastrointestinal symptoms are frequently observed in patients with bipolar affective disorder, but the causal relationship between these conditions remains unclear. To establish causality, this study utilized Mendelian randomization (MR) with data from large-scale genomic research. The investigation aimed to elucidate the relationship between emotional states, bipolar disorder, and functional gastrointestinal disorders (FGIDs). MethodsSummary statistics from GWAS were utilized for mood swings (UK biobank, N = 451,619), irritable mood (UK biobank, N = 373,733), bipolar disorder (UK biobank, N = 352,006),functional dyspepsia (FinnGen biobank, N = 194,071), and irritable bowel syndrome (UK biobank, N = 486,601). All GWAS summary statistics were derived from individuals of European ancestry. The primary analysis employed the inverse variance-weighted method for Mendelian randomization (MR). Additionally, we conducted tests for heterogeneity and pleiotropy to ensure the robustness of our results. ResultsA suggestive positive causal relationship was identified between mood swings-related conditions and IBS using the inverse variance-weighted (IVW) method [mood swings-IBS: OR/95%CI: 3.221(2.417,4.294), P(1.42E−15); irritable mood-IBS: OR/95%CI: 1.881(1.615,2.191), P(4.56E−16); bipolar disorder-IBS: OR/95%CI: 1.003(1.001,1.006), P(0.009)]. For functional dyspepsia, a suggestive positive causal relationship was observed with mood swings [mood swings-FD: OR/95%CI: 2.827(1.124,7.109), P(0.027)]. In the reverse analysis, causal relationship was observed between IBS and emotional states [IBS and mood swings: OR/95%CI: 1.030(1.021,1.040), P(1.10E−10); IBS and irritable mood: OR/95%CI: 1.064(1.041,1.087), P(2.58E−08)]. ConclusionsMood swings, irritable mood, and bipolar disorder were associated with an increased risk of functional gastrointestinal disorders (FGIDs). Additionally, reverse analysis revealed a causal relationship between irritable bowel syndrome (IBS) and both mood swings and irritable mood. These findings suggest that targeted emotional interventions may be beneficial for patients with FGIDs. Further research is warranted to explore the relationship between mood instability-related disorders and FGIDs, particularly IBS.

Physical activity, sedentary behavior, and the risk of functional gastrointestinal disorders: A two-sample Mendelian randomization study.

Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are prevalent functional gastrointestinal disorders (FGIDs). In this study we aimed to explore the causal association between physical activity or sedentary behavior and the risk of FD and IBS. Mendelian randomization (MR) analysis was employed. Candidate genetic instruments for physical activity and sedentary behavior were retrieved from the latest published Genome-Wide Association Study (GWAS), which included up to 703 901 participants. Summary-level GWAS data for FD (8 875 cases and 320 387 controls) and IBS (9 323 cases and 301 931 controls) were obtained from the FinnGen study. The causal effects were mainly estimated by inverse variance weighted (IVW) method. Sensitivity analyses were implemented with Cochran's Q test, MR-Egger intercept test, leave-one-out analysis, and the funnel plot. No significant association of moderate-to-vigorous intensity physical activity (MVPA), leisure screen time (LST), sedentary behavior at work (SDW), and sedentary commuting (SDC) with the risk of FD was found. However,there was a suggestive correlation between MVPA and the decreased risk of FD (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.39-0.99, P = 0.047). Genetically predicted MVPA decreased the risk of IBS (OR 0.58, 95% CI 0.40-0.84, P = 0.004), while increased LST was positively associated with IBS risk (OR 1.33, 95% CI 1.15-1.53, P < 0.001). No causal effects of SDW or SDC on IBS risk were observed. MVPA and LST are causally linked to the development of IBS, which will facilitate primary prevention of IBS.

Association of mental health conditions and functional gastrointestinal disorders among Vietnamese new-entry medical students.

Functional gastrointestinal disorders (FGIDs), also known as disorders of gut-brain interaction, occur not only in the elderly but also in young adults. This study aimed to evaluate the association between mental health conditions and FGIDs among Vietnamese new-entry medical students. This cross-sectional study was conducted in February 2022 among new-entry medical students in Ho Chi Minh City, Vietnam. A printed questionnaire was distributed to all students on the day of freshmen health screening. Their urine samples were collected to screen for Helicobacter pylori infection using rapid urinary test. FGIDs were diagnosed using ROME IV criteria. Gastroesophageal reflux disease (GERD) was defined as the presence of typical reflux symptoms at least twice a week. Mental health conditions, including generalized anxiety disorder (GAD) and major depressive disorder (MDD), were identified using Generalized Anxiety Disorder Assessment-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales, respectively. Among 400 new-entry medical students who participated in the study, the overall prevalence of FGIDs was 10.3% (functional dyspepsia 6.5%, irritable bowel disease 5.5%). The overlap syndrome (OS) of GERD-FGIDs or different FGIDs was present in 3.0% of participants. The prevalences of GAD and MDD were 6.8% and 10.2%, respectively. The urinary test was positive in 180 (45.0%) participants. In the multivariable logistic regression analysis, MDD was significantly associated with not only the risk of FGIDs (OR = 5.599, 95%CI: 2.173-14.430, p<0.001) but also the risk of OS (OR = 10.076, 95CI%: 2.243-45.266, p = 0.003). MDD is associated with FGIDs and OS among new-entry medical students.

Chronic obstructive pulmonary disease is associated with a higher risk of functional gastrointestinal disorders

RationaleThe association between chronic obstructive pulmonary disease (COPD) and functional gastrointestinal disorders (FGIDs) remains unclear. MethodsUsing Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to explore the relationship of COPD and future FGIDs development. The COPD cohort consisted of 4107 patients with COPD between 2000 and 2005. For a comparison cohort, 12,321 age- and gender-matched patients without COPD were randomly selected. The two cohorts were tracked for 5 year and observed for occurrence of FGIDs. The operational definition of COPD in the Korean Health Insurance Review and Assessment Service database was used to validate the results. The validation study confirmed the accuracy of definitions of COPD (83.5% sensitivity). ResultsThe adjusted hazard ratios (aHR) of FGIDs in patients with COPD was higher (aHR: 1.63; 95% confidence interval (CI): 1.45–1.83; P < .001) than that of the comparison patients. In our secondary analysis in which FGIDs was divided into gastroesophageal reflux disease, irritable bowel syndrome and functional dyspepsia. Patients with COPD also had higher risk for all three subtypes of FGIDs: irritable bowel syndrome (aHR: 1.55; 95% confidence interval (CI): 1.27–1.90; P < .001), gastroesophageal reflux disease (aHR: 2.10; 95% confidence interval (CI): 1.76–2.49; P < .001), and functional dyspepsia (aHR: 1.34; 95% confidence interval (CI): 1.11–1.62; P = .003). The results in validated COPD group were consistent with those in unvalidated COPD group. ConclusionPatients with COPD appeared to be at higher risk for future FGIDs.

Adherence to the Mediterranean diet and risk of functional constipation in children in Turkey: case–control study

Background: Functional constipation is often seen in children, affecting quality of life and imposing a considerable burden on health care services. The Mediterranean diet is associated with a lower risk of functional gastrointestinal disorders. Aims: This study aimed to evaluate the relationship between functional constipation and adherence to the Mediterranean diet in Turkish children aged 6–18 years. Methods: In this case–control study, 221 children with functional constipation (cases) were selected from a paediatric gastroenterology clinic between May 2018 and September 2019, and 230 children without constipation (controls) were randomly selected from those attending a well-child check-up. Cases and controls were matched on sex, age and socioeconomic characteristics. Compliance with the Mediterranean diet was assessed using the KIDMED index score. Multivariable logistic regression analysis was used to analyses the data. Results: KIDMED index scores in cases and controls were 4.0 (SD = 2.5) and 6.3 (SD = 2.4), respectively (P &lt; 0.001). Odds ratios for functional constipation were 0.23 (95% confidence interval (CI): 0.13–0.38) for KIDMED index score 4–7 and 0.05 (95% CI: 0.03–0.11) for score ≥ 8 compared with the lowest category (score ≤ 3; P &lt; 0.001). A negative correlation was observed between age and adherence to the Mediterranean diet. Conclusion: Good adherence to the Mediterranean diet was associated with a lower risk of functional constipation, and adherence to the Mediterranean diet decreased with age. Education on nutrition and health is warranted to help maintain and improve the health of young people in Turkey.

The Association between Intimate Partner Violence and Functional Gastrointestinal Disorders and Symptoms among Adult Women: Systematic Review

Functional gastrointestinal disorders (FGIDs) and symptoms have been identified as possible health consequences of intimate partner violence (IPV). However, whether specific types of abuse (i.e., psychological, physical and sexual) are associated with FGIDs and the implications of FGIDs for women’s quality of life (QOL) in the context of IPV are not well understood. This systematic review examined the association between the different types of IPV and the risk of FGIDs and symptoms among adult women and assessed the impact of FGIDs and symptoms on women’s QOL. Seven electronic databases were searched using the following criteria: English language studies of adult women (15 years or older) who had experienced IPV and reported FGIDs and symptoms; both quantitative and qualitative studies were included, and no time frame for publication was specified. A total of 15 studies (14 quantitative, 1 qualitative) conducted in 9 countries satisfied our inclusion criteria. IPV was associated with increased odds (1.6 to 2.7) of reporting a FGID. Each type of IPV (physical, sexual, psychological) was associated with FGIDs, alone or in combination. FGIDs were associated with some aspects of women’s QOL in the context of IPV (specifically seeking health care). Attention to the association between IPV and FGIDs could help strengthen health care for women who have experienced IPV and are suffering from FGIDs and inform future research to understanding this association in more depth.

Microbiota and gut-brain axis dysfunction in autism spectrum disorder: Evidence for functional gastrointestinal disorders.

The high frequency of functional gastrointestinal disorders (FGIDs) in autism spectrum disorders (ASD) has drawn attention to the composition of gut microbiota as a possible factor in ASD pathogenesis. However, characterization of a distinctive ASD microbial pattern is still unclear. To conduct a narrative review on ASD microbial profile and diversity changes relative to NT children and FGID comorbidity and ASD pathogenesis. First, we searched the PubMed database in peer-reviewed journals for evidence regarding the current epidemiological evidence on FGID comorbidity. For the identification of a microbial profile in ASD children, only original studies examining gut bacterial and fungal abundances and diversity in ASD children and adolescents were included. Lastly, research on the role of microbial dysbiosis as an interface between genetic and environmental risk factors in the pathogenesis of neuropsychiatric disorders, and specifically ASD, was examined. Prevalence and risk of FGIDs is significantly higher in ASD children and correlates with the severity of ASD. Bacterial and fungal diversity differ between ASD and NT children, indicating a difference in taxonomic abundance profiles, which have been reported at all bacterial phylogenetic levels. However, studies analyzing gut microbiota have a heterogeneous methodology and several limitations that could account for the variety of findings for each taxon. Also, covariate analysis reveals influence of demographics, diet, disease severity, GI comorbidity and allergies. Integration of these findings with changes in metabolome and genetic risk factors allowed for a better understanding of microbiota involvement in ASD pathogenesis for future research.

Neonatal Antibiotics and Prematurity Are Associated with an Increased Risk of Functional Gastrointestinal Disorders in the First Year of Life

To assess the prevalence of functional gastrointestinal disorders (FGIDs) in the first year of life and the influence of different neonatal factors on development of FGIDs. A prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up until 1year. Gestational age, neonatal antibiotic administration, duration of hospitalization, mode of delivery, birth weight, and feeding pattern were recorded. FGIDs were classified according to Rome III criteria and assessed at 1, 3, 6, and 12months of life. Among 1152 newborns enrolled, 934 (81.1%) completed the study, 302 (32%) were newborns born preterm, 320 (34%) had neonatal antibiotics, and 718 (76.9%) had at least 1 FGID according to Rome III criteria (443 [47.4%] infantile colic, 374 [40.0%] regurgitation, 297 [31.8%] infant dyschezia, 248 [26.6%] functional constipation, and 34 [3.6%] functional diarrhea) throughout the first year of life. The proportion of infants born preterm presenting with FGIDs (86%) was significantly greater compared with infants born full term (72.5%) (χ2=21.3, P=.0001). On multivariate analysis, prematurity and neonatal use of antibiotics was significantly associated with at least 1 FGID. We found a high rate FGIDs in infants, likely related to the population recruited, the long observation period, the diagnosis based on Rome III criteria, and parental reports. Preterm delivery and neonatal use of antibiotics in the first months of life are associated with an increased incidence of FGIDs, particularly infantile colic and regurgitation. In our population, cesarean delivery and feeding pattern at 1month of life emerged as additional risk factors for infant dyschezia and functional diarrhea. Other neonatal factors associated with FGIDs need to be further explored.

Fast foods--are they a risk factor for functional gastrointestinal disorders?

Fast-food consumption has greatly increased in Taiwan. Frequent fast food intake is associated with both allergy and obesity. The aim of this study was to describe fast food habit changes, and to assess the relationship between fast food intake and the risk of functional gastrointestinal disorders (FGIDs) among Taiwanese adolescents. This analysis used data from the Nutrition and Health Survey in Taiwan (NAHSIT) of high school students conducted in 2011. A total of 2,042 adolescents (12-19 years) completed the questionnaire. The survey included the Rome III criteria for FGIDs, translated into Chinese for adolescents. Respondents with previously diagnosed chronic organic gastrointestinal diseases were excluded from the study. In total, 2,034 children were enrolled. 545 subjects (26.8%) had history of at least one FGID. 88.1% of the subjects reported fast foods consumption. A significantly higher prevalence of FGIDs was noted in adolescents with a history of fast foods consumption, compared with those reported not to have ingested fast foods in the past 30 days (27.6% vs 20.6%, p=0.024). An increased risk of FGIDs in children and adolescents was associated with fast food intake (OR 1.8, 95% CI: 1.78-1.83). FGIDs were common among Taiwanese adolescents. Fast-food consumption may contribute to a positive association with the development of functional gastrointestinal disorders. Lower fiber intake and more frozen desserts in the diet may be complicit in FGIDs. The findings have public health relevance in regard to the global increase in fast food consumption.

Mo1326 Increased Risk of Functional Gastrointestinal Disorders (FGIDs) in Obesity Patients

Mo1326 Increased Risk of Functional Gastrointestinal Disorders (FGIDs) in Obesity Patients

Su1260 Prevalence of Functional Gastrointestinal Disorders – A Large Multisite Study in Colombian School Children

The prevalence of pediatric functional gastrointestinal disorders (FGIDs) in Latin America remains largely unknown. There have been few published studies with small sample size and poor external validity. Aims: To assess the prevalence and risk factors of FGIDS in children in several cities in Colombia. Methods: A large multisite study in school children. The QPGS was translated from English into Spanish with reverse translation into English following validated standard methods by our group. Adequate understanding of the terms used in the QPGS by the children was established. School-children of public and private schools of 7 geographically dispersed mid and large cities in Colombia (Cali, Sotavento, Pereira, Cucuta, Soledad, Pasto, Bogota) completed the Rome III Questionnaire of Pediatric Gastrointestinal Symptoms (QPGS). Sociodemographic, family structure information and medical history were obtained from parents. Anthropometrics were measured and children were plotted into growth curves. Children with a history of an organic GI disorder were excluded. Results: 3483 children were enrolled (mean age, 11.3 +2.2 years). 25.1% school children were diagnosed with FGIDs: 13.2% constipation, 4.9% irritable bowel syndrome, 2.6% functional abdominal pain/syndrome, 1.1% aerophagia, 1.1% abdominal migraine. Females (OR: 1.4 CI: 1.2-1.6), public school (OR: 1.3 CI 1.12-1.57), separated parents (OR: 1.22 CI 1.01-1.48), only child (OR: 1.2 CI: 1.1-1.6) were associated with risk for FGIDs. Malnutrition and growth failure were not significantly associated with FGIDs. Conclusion: This is the first multisite city to investigate the prevalence of FGIDs in Latin American children. FGIDs are common in Colombian school children. Female gender, attending public school, children of separated parents and being an only child were associated with a higher risk for FGIDs.

Pathogen-specific Risk of Functional Gastrointestinal Disorders, Gastroesophageal Reflux Disease and Celiac Disease Following Acute Enteric Infection

Purpose: The U.S. CDC recently estimated over 2 million foodborne illnesses are annually caused by 4 major enteropathogens: Salmonella spp., Campylobacter spp., Shigella spp. and Yersinia enterocoltica. The costs of these infections are over $152 billion annually and are associated with significant numbers of outpatient visits, hospitalizations and deaths. Pathogen-specific risk estimates of chronic sequelae are lacking. We utilized a Dept. of Defense medical encounter database to evaluate the risk of functional gastrointestinal disorders (FGD) and celiac disease (CD) following select foodborne infections. Methods: Subjects with acute gastroenteritis between 1998 to 2009 attributed to Salmonella (nontyphoidal) spp., Shigella spp., Campylobacter spp. or Yersinia enterocolitica, were matched with ≥4 subjects with unrelated diagnoses. Medical history was analyzed for the duration of military service time (or a minimum of 1 year) to assess for incident FGD or CD. Relative risks were calculated using Poisson regression to determine the relationship between pathogen-attributable gastroenteritis and several sequelae while controlling for covariates. Results: A total of 1,753 pathogen-specific gastroenteritis cases (Campylobacter: 738, Salmonella,: 624, Shigella: 376, Yersinia: 17) were identified and followed for a median of 3.8 years (interquartile range: 2.1, 6.7). The incidence (per 100,000 person-years) of PI sequelae was as follows: IBS, 3.0; dyspepsia, 1.8; constipation, 3.9; gastroesophageal reflux disease (GERD), 9.2; CD, 0.07. After controlling for important demographic covariates, we found pathogenspecific increased risks (Table 1).Table 1: Adjusted relative risks (95% confidence interval) of multiple sequelae following pathogen-specific gastroenteritisConclusion: These data confirm previous studies demonstrating risk of postinfection IBS following Shigella, Salmonella and Campylobacter infections, but find even higher risk following Yersinea enterocolita infections likely secondary to [unique pathology associated with this pathogen]. In addition, novel associations with other functional disorders (dyspepsia and Campylobacter, constipation and Shigella/Campylobacter). Other novel associations were increased risk of GERD after Campylobacter and Shigella infections, and higher risk of celiac disease after Campylobacter. These data highlight the additional preventable burden of disease associated with these infections which should inform better food security policies and practices, as well as prompt further research into pathogenic mechanisms associated with these infections and outcomes.

Risk of Functional Gastrointestinal Disorders in U.S. Military Following Self-Reported Diarrhea and Vomiting During Deployment

Military personnel are frequently deployed to regions of the world with high travelers' diarrhea (TD) rates. Pathogens associated with TD have been linked to several post-infectious sequelae, including functional gastrointestinal disorders (FGD), such as irritable bowel syndrome (IBS) and functional dyspepsia. Furthermore, stress associated with deployment may potentiate the increased FGD risk. We sought to assess whether self-reported diarrhea, vomiting, and stressors during deployment were associated with increased FGD risk. Using active duty military medical encounter data from the Defense Medical Surveillance System (DMSS), we conducted a matched case-control study to assess the odds of FGD (IBS, functional constipation, functional diarrhea, dyspepsia) following self-reported diarrhea or vomiting during deployment. Only first-time deployers with detailed self-reporting of deployment-related exposures from 2008 and 2009 were included. Univariate and multivariate analyses were performed. A total of 129 cases of FGD were identified, with the following distribution: constipation (n=67), dyspepsia (n=15), IBS (n=22), and overlapping disorders (n=25). Diarrhea and/or vomiting during deployment were significantly associated with the development of FGD. Other demographic factors were also associated with variable risk. We found no consistent effect of war-related stressors or non-combat-related correlates of stress. Deployment-related TD is common in deployed military personnel and is associated with an increased risk of several FGD. When considering effective countermeasures and mitigation strategies, both the acute effects and chronic sequelae of enteric infections should be considered. Increased emphasis on existing and novel primary prevention strategies are needed, as well as outcome studies among those developing these conditions.

Somatic Complaints in Childhood Functional Abdominal Pain Are Associated With Functional Gastrointestinal Disorders in Adolescence and Adulthood

Nongastrointestinal (non-GI) somatic complaints are common in children and adults with functional gastrointestinal disorders (FGIDs). The aim of the present study was to determine whether non-GI somatic complaints in children with functional abdominal pain (FAP) were associated with FGIDs in adolescence and young adulthood. In a prospective clinic-based study, children and adolescents (ages 8-16 years) with FAP (n = 188) and well controls (n = 61) completed a validated measure of somatic symptoms. Participants were assessed 4 to 15 years later (as older adolescents and young adults) for presence of current FGIDs as defined by the Rome III criteria. Of the 188 youths with pediatric FAP, 35.6% met criteria for FGIDs at follow-up. Initial levels of non-GI somatic symptoms were significantly higher in pediatric FAP participants who subsequently met criteria for FGIDs at follow-up compared with controls and pediatric FAP participants who did not meet criteria for FGIDs at follow-up. The association of non-GI somatic symptoms with FAP in children may identify a group that is at risk for FGIDs later in life.

Risk of Functional Gastrointestinal Disorders in US Military Following Self-reported Diarrhea During Deployment

Risk of Functional Gastrointestinal Disorders in US Military Following Self-reported Diarrhea During Deployment

The Incidence and Gastrointestinal Infectious Risk of Functional Gastrointestinal Disorders in a Healthy US Adult Population

Functional gastrointestinal disorders (FGDs) are recognized sequelae of infectious gastroenteritis (IGE). Within the active duty military population, a group with known high IGE rates, the population-based incidence, risk factors, and attributable burden of care referable to FGD after IGE are poorly defined. Using electronic medical encounter data (1999-2007) on active duty US military, a matched, case-control study describing the epidemiology and risk determinants of FGD (irritable bowel syndrome (IBS), functional constipation (FC), functional diarrhea (FD), dyspepsia (D)) was conducted. Incidence rates and duration of FGD-related medical care were estimated, and conditional logistic regression was utilized to evaluate FGD risk after IGE. A total of 31,866 cases of FGD identified were distributed as follows: FC 55% (n=17,538), D 21.2% (n=6,750), FD 2.1% (n=674), IBS 28.5% (n=9,091). Previous IGE episodes were distributed as follows: specific bacterial pathogen (n=65, 1.2%), bacterial, with no pathogen specified (n=2155, 38.9%), protozoal (n=38, 0.7%), viral (n=3431, 61.9%). A significant association between IGE and all FGD (odds ratio (OR) 2.64; P<0.001) was seen, with highest risk for FD (OR 6.28, P<0.001) and IBS (OR 3.72, P<0.001), and moderate risk for FC (2.15, P<0.001) and D (OR 2.39, P<0.001). Risk generally increased with temporal proximity to, and bacterial etiology of, exposure. Duration of FGD-related care was prolonged with 22.7% having FGD-associated medical encounters 5 years after diagnosis. FGD are common in this population at high risk for IGE. When considering effective countermeasures and mitigation strategies, attention directed toward prevention as well as the acute and chronic sequelae of these infections is needed.