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Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study

Sperber AD 1 , Bangdiwala SI 2 , Drossman DA 3 , Ghoshal UC 4 , Simren M 5 , Tack J 6 Show all authors , Whitehead WE 7 , Dumitrascu DL 8 , Fang X 9 , Fukudo S 10 , Kellow J 11 , Okeke E 12 , Quigley EMM 13 , Schmulson M 14 , Whorwell P 15 , Archampong T 16 , Adibi P 17 , Andresen V 18 , Benninga MA 19 , Bonaz B 20 , Bor S 21 , Fernandez LB 22 , Choi SC 23 , Corazziari ES 24 , Francisconi C 25 , Hani A 26 , Lazebnik L 27 , Lee YY 28 , Mulak A 29 , Rahman MM 30 , Santos J 31 , Setshedi M 32 , Syam AF 33 , Vanner S 34 , Wong RK 35 , Lopez-Colombo A 36 , Costa V 26 , Dickman R 37 , Kanazawa M 10 , Keshteli AH 38 , Khatun R 39 , Maleki I 40 , Poitras P 41 , Pratap N 42 , Stefanyuk O 43 , Thomson S 32 , Zeevenhooven J 19 , Palsson OS 7

Affiliations 

  • 1 Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: [email protected]
  • 2 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
  • 3 Center for Functional GI & Motility Disorders, University of North Carolina, Center for Education and Practice of Biopsychosocial Care, and Drossman Gastroenterology, Chapel Hill, North Carolina
  • 4 Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, India
  • 5 Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • 6 Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
  • 7 Center for Functional GI & Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
  • 8 Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • 9 Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • 10 Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
  • 11 Discipline of Medicine, Northern Clinical School, University of Sydney, Sydney, Australia
  • 12 Department of Medicine, University of Jos, Jos University Teaching Hospital, Jos, Nigeria
  • 13 Lynda K. and David M. Underwood Center for Digestive Disorder, Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas
  • 14 Laboratory of Liver, Pancreas and Motility (HIPAM), Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autónoma de Mexico (UNAM). Hospital General de México, Mexico City, Mexico
  • 15 Neurogastroenterology Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
  • 16 Department of Medicine, University of Ghana School of Medicine and Dentistry, Accra, Ghana
  • 17 Integrative Functional Gastroenterology Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • 18 Department of Medicine, Israelitic Hospital, Hamburg, Germany
  • 19 Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands
  • 20 Service d'Hépato-Gastroentérologie, CHU Grenoble Alpes, Grenoble, France
  • 21 Ege University School of Medicine, Division of Gastroenterology, Bornova Izmir, Turkey
  • 22 "Centro Medico Dr. Bustos Fernandez", Buenos Aires, Argentina
  • 23 Department of Gastroenterology, School of Medicine, Wonkwang University, Iksan, Korea
  • 24 Department of Gastroenterology, Istituto Clinico Humanitas, Rozzano, Italy
  • 25 Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Gastroenterology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
  • 26 Gastroenterology Unit, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
  • 27 Department of Outpatient Medicine, Faculty of Internal Medicine, Moscow State University of Medicine and Dentistry, Moscow, Russia
  • 28 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
  • 29 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
  • 30 Dhaka Medical College & Hospital, Dhaka, Bangladesh
  • 31 Department of Gastroenterology, University Hospital Vall d'Hebron, Autonomous University of Barcelona & Neuro-Inmuno-Gastroenterology Lab, Vall d'Hebron Research Institute, Barcelona, Spain
  • 32 Department of Medicine, Division of Gastroenterology, University of Cape Town, Cape Town, South Africa
  • 33 Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • 34 Gastrointestinal Diseases Research Unit, Kingston Health Science Centre, Queen's University, Kingston, Ontario, Canada
  • 35 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
  • 36 UMAE Hospital de Especialidades C.M.N. Manuel Avila Camacho, Puebla Pue, Mexico
  • 37 Division of Gastroenterology, Rabin Medical Center, Sackler School of Medicine, Tel-Aviv, Israel
  • 38 CEGIIR-Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
  • 39 Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
  • 40 Gut and Liver Research Center, Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  • 41 CHUM, Université de Montréal, Montréal, Quebec, Canada
  • 42 KIMS Hospitals, Secunderabad, India
  • 43 Department of Biochemical Markers of Chronic Non-Communicable Diseases Research National Medical Research Centre for Preventive Medicine, Moscow, Russia
Gastroenterology, 2021 01;160(1):99-114.e3.
PMID: 32294476 DOI: 10.1053/j.gastro.2020.04.014

Abstract

BACKGROUND & AIMS: Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents.

METHODS: Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately.

RESULTS: Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval [CI], 39.9-40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2-21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6-1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3-1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%).

CONCLUSIONS: In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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