TY - JOUR
T1 - Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life
AU - Sperber, Ami D.
AU - Freud, Tamar
AU - Aziz, Imran
AU - Palsson, Olafur S.
AU - Drossman, Douglas A.
AU - Dumitrascu, Dan L.
AU - Fang, Xuicai
AU - Fukudo, Shin
AU - Ghoshal, Uday C.
AU - Kellow, John
AU - Khatun, Rutaba
AU - Okeke, Edith
AU - Quigley, Eamonn M.M.
AU - Schmulson, Max
AU - Simren, Magnus
AU - Tack, Jan
AU - Whitehead, William E.
AU - Whorwell, Peter
AU - Bangdiwala, Shrikant I.
N1 - Funding Information:
Funding The Rome Foundation Global Epidemiology study was funded, in part, by research grants from Ironwood, Shire, Allergan, and Takeda. The study in Israel was funded by Takeda-Israel. The study in Romania was funded by the Romanian Society of Neurogastroenterology. None of the funders was involved in the planning, design, implementation, statistical analyses or any other aspect of the study including preparation of the paper or knowledge of its contents.
Funding Information:
Conflicts of interest These authors disclose the following: Ami D. Sperber has served as consultant for Lapidot Israel and AbbVie-Israel outside the submitted work. Olafur S. Palsson has received a research contract from the Rome Foundation during the conduct of the study; and received research contract from Glycom A/S and personal fees from metaMe Health, outside the submitted work. Douglas A. Drossman has received personal fees from Olorinab, Shire, and Ironwood, outside the submitted work. Dan L. Dumitrascu has received speaker fees and/or advisory board fees from AlfaSigma, Abbott, AbbVie, Biocodex, Menarini, Pfizer, SECOM, Biessen, Sanofi, Terapia, and R&B, outside the submitted work. Max Schmulson has received grants, personal fees, and other fees from Takeda Mexico and Alfasigma Mexico; received personal fees from Carnot and Gemelli Biotech Corp; and received other fees from Ferrer Mexico, outside the submitted work. Magnus Simren has received grants and personal fees from Gkycom and Danone Nutricia Research; personal fees from Ironwood, Menarini, Biocodex, Adnovate, Arena, Tillotts, Kyowa Kirin, Takeda, Alimentary Health, AlfaSigma, and the Falk Foundation; and grants from Genetic Analysis AS, outside the submitted work. Jan Tack has given scientific advice to Adare, AlfaWassermann, Allergan, Arena, Bayer, Christian Hansen, Clasado, Danone, Devintec, Falk, Gr?nenthal, Ironwood, Janssen, Kiowa Kirin, Menarini, Mylan, Neurogastrx, Neutec, Novartis, Noventure, Nutricia, Shionogi, Shire, Takeda, Theravance, Tramedico, Truvion, Tsumura, Zealand, and Zeria Pharmaceutical; received research support from Shire, Sofar, and Tsumura; and served on the Speakers Bureau for Abbott, Allergan, AstraZeneca, Janssen, Kyowa Kirin, Menarini, Mylan, Novartis, Shire, Takeda, Truvion, and Zeria Pharmaceutical, all outside the submitted work. William E. Whitehead has received discounted equipment provided by Medspira for a research study, test kits for dextranomer injections to treat fecal incontinence from Palette Life Sciences, and a contribution from Glycom for a research fund to support an international collaborator, outside the submitted work, and none of these contributions came to the investigator directly. Peter Whorwell has served as a consultant to or received research funding from Danone, Allergan Phazrma, Ironwood Pharma, Salix Pharma, 4D Pharma, and Enteromed Ltd, all outside of the submitted work. The remaining authors disclose no conflicts. Funding The Rome Foundation Global Epidemiology study was funded, in part, by research grants from Ironwood, Shire, Allergan, and Takeda. The study in Israel was funded by Takeda-Israel. The study in Romania was funded by the Romanian Society of Neurogastroenterology. None of the funders was involved in the planning, design, implementation, statistical analyses or any other aspect of the study including preparation of the paper or knowledge of its contents.
Funding Information:
Conflicts of interest These authors disclose the following: Ami D. Sperber has served as consultant for Lapidot Israel and AbbVie-Israel outside the submitted work. Olafur S. Palsson has received a research contract from the Rome Foundation during the conduct of the study; and received research contract from Glycom A/S and personal fees from metaMe Health, outside the submitted work. Douglas A. Drossman has received personal fees from Olorinab, Shire, and Ironwood, outside the submitted work. Dan L. Dumitrascu has received speaker fees and/or advisory board fees from AlfaSigma, Abbott, AbbVie, Biocodex, Menarini, Pfizer, SECOM, Biessen, Sanofi, Terapia, and R&B, outside the submitted work. Max Schmulson has received grants, personal fees, and other fees from Takeda Mexico and Alfasigma Mexico; received personal fees from Carnot and Gemelli Biotech Corp; and received other fees from Ferrer Mexico, outside the submitted work. Magnus Simren has received grants and personal fees from Gkycom and Danone Nutricia Research; personal fees from Ironwood, Menarini, Biocodex, Adnovate, Arena, Tillotts, Kyowa Kirin, Takeda, Alimentary Health, AlfaSigma, and the Falk Foundation; and grants from Genetic Analysis AS, outside the submitted work. Jan Tack has given scientific advice to Adare, AlfaWassermann, Allergan, Arena, Bayer, Christian Hansen, Clasado, Danone, Devintec, Falk, Grünenthal, Ironwood, Janssen, Kiowa Kirin, Menarini, Mylan, Neurogastrx, Neutec, Novartis, Noventure, Nutricia, Shionogi, Shire, Takeda, Theravance, Tramedico, Truvion, Tsumura, Zealand, and Zeria Pharmaceutical; received research support from Shire, Sofar, and Tsumura; and served on the Speakers Bureau for Abbott, Allergan, AstraZeneca, Janssen, Kyowa Kirin, Menarini, Mylan, Novartis, Shire, Takeda, Truvion, and Zeria Pharmaceutical, all outside the submitted work. William E. Whitehead has received discounted equipment provided by Medspira for a research study, test kits for dextranomer injections to treat fecal incontinence from Palette Life Sciences, and a contribution from Glycom for a research fund to support an international collaborator, outside the submitted work, and none of these contributions came to the investigator directly. Peter Whorwell has served as a consultant to or received research funding from Danone, Allergan Phazrma, Ironwood Pharma, Salix Pharma, 4D Pharma, and Enteromed Ltd, all outside of the submitted work. The remaining authors disclose no conflicts.
Publisher Copyright:
© 2022 AGA Institute
PY - 2022/5
Y1 - 2022/5
N2 - BACKGROUND AND AIMS: Conditions such as irritable bowel syndrome (IBS), functional dyspepsia, and functional constipation are among the prevalent gastrointestinal (GI) disorders classified as disorders of gut-brain interaction (DGBI), which can adversely affect the lives of sufferers. This study aimed to assess the degree and consequences of overlapping DGBI in a large population-based global scale.METHODS: Internet survey data from 54,127 adults (49.1% women) in 26 countries were analyzed by 4 GI anatomic regions (esophageal, gastroduodenal, bowel, and anorectal). The number of DGBI-affected GI regions was assessed, including associations with sex, age, disease severity, quality of life, psychosocial variables, and health care utilization.RESULTS: A total of 40.3% of surveyed individuals met Rome IV criteria for a DGBI. The percentages with 1-4 DGBI-affected GI regions were 68.3%, 22.3%, 7.1%, and 2.3%, respectively. The IBS symptom severity score increased significantly from 1 (207.6) to 4 (291.6) regions, as did non-GI symptom reporting (somatization), anxiety and depression, concerns and embarrassment about bowel function, doctor visits, medications, and abdominal surgeries (all P < .0001). Quality of life decreased with increasing number of DGBI regions (P < .0001). In a logistic mixed model, non-GI symptoms (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.08-1.10), being very vs not concerned (OR, 2.55; 95% CI, 2.27-2.90), being very vs not embarrassed about bowel function (OR, 1.20; 95% CI, 1.08-1.33), and mean number of doctor visits (OR, 1.23; 95% CI, 1.115-1.32) were most strongly associated with number of DGBI regions.CONCLUSIONS: DGBI in multiple anatomic GI regions is associated with increased psychological comorbidity, health care utilization, and IBS severity. Physician awareness of overlap could improve quality of care, prevent unnecessary interventions, and yield more positive health outcomes.
AB - BACKGROUND AND AIMS: Conditions such as irritable bowel syndrome (IBS), functional dyspepsia, and functional constipation are among the prevalent gastrointestinal (GI) disorders classified as disorders of gut-brain interaction (DGBI), which can adversely affect the lives of sufferers. This study aimed to assess the degree and consequences of overlapping DGBI in a large population-based global scale.METHODS: Internet survey data from 54,127 adults (49.1% women) in 26 countries were analyzed by 4 GI anatomic regions (esophageal, gastroduodenal, bowel, and anorectal). The number of DGBI-affected GI regions was assessed, including associations with sex, age, disease severity, quality of life, psychosocial variables, and health care utilization.RESULTS: A total of 40.3% of surveyed individuals met Rome IV criteria for a DGBI. The percentages with 1-4 DGBI-affected GI regions were 68.3%, 22.3%, 7.1%, and 2.3%, respectively. The IBS symptom severity score increased significantly from 1 (207.6) to 4 (291.6) regions, as did non-GI symptom reporting (somatization), anxiety and depression, concerns and embarrassment about bowel function, doctor visits, medications, and abdominal surgeries (all P < .0001). Quality of life decreased with increasing number of DGBI regions (P < .0001). In a logistic mixed model, non-GI symptoms (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.08-1.10), being very vs not concerned (OR, 2.55; 95% CI, 2.27-2.90), being very vs not embarrassed about bowel function (OR, 1.20; 95% CI, 1.08-1.33), and mean number of doctor visits (OR, 1.23; 95% CI, 1.115-1.32) were most strongly associated with number of DGBI regions.CONCLUSIONS: DGBI in multiple anatomic GI regions is associated with increased psychological comorbidity, health care utilization, and IBS severity. Physician awareness of overlap could improve quality of care, prevent unnecessary interventions, and yield more positive health outcomes.
KW - DGBI
KW - Epidemiology
KW - Functional Disorders
KW - Overlap
KW - Psychosocial
KW - Severity of Illness Index
KW - Brain
KW - Irritable Bowel Syndrome/diagnosis
KW - Humans
KW - Male
KW - Gastrointestinal Diseases/diagnosis
KW - Rome
KW - Quality of Life
KW - Adult
KW - Female
KW - Surveys and Questionnaires
UR - http://www.scopus.com/inward/record.url?scp=85128003368&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85128003368&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2021.05.042
DO - 10.1016/j.cgh.2021.05.042
M3 - Article
C2 - 34052391
AN - SCOPUS:85128003368
SN - 1542-3565
VL - 20
SP - e945-e956
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 5
ER -