Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Gastroenterology. 2021 Jan;160(1):99-114.e3. doi: 10.1053/j.gastro.2020.04.014. Epub 2020 Apr 12.
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.
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.
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%).
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.
尽管功能性胃肠病(FGIDs),现在称为肠脑互动障碍,对医疗保健系统有重大的经济影响,并对生活质量产生不利影响,但对其全球流行率和分布知之甚少。我们调查了六大洲 33 个国家中 22 种 FGIDs 的流行率和相关因素。
使用罗马 IV 诊断问卷、罗马 III 肠易激综合征问卷和 80 个项目,通过互联网在 24 个国家收集数据,在 7 个国家进行个人访谈,在 2 个国家同时进行这两种方式收集数据,以确定与 FGIDs 相关的变量。由于互联网和家庭组的收集方法不同,因此分别进行和报告数据分析。
在 73076 名成年受访者(49.5%为女性)中,完成互联网调查的 40.3%(95%置信区间[CI],39.9-40.7)和完成家庭调查的 20.7%(95%CI,20.2-21.3)的人符合至少 1 种 FGIDs 的诊断标准。基于互联网调查(比值比,1.7;95%CI,1.6-1.7)和家庭调查(比值比,1.3;95%CI,1.3-1.4)的结果,女性 FGIDs 的患病率高于男性。FGIDs 与生活质量较低和更频繁的就诊有关。与罗马 III 标准相比,使用罗马 IV 标准时,互联网调查中肠易激综合征的比例较低(4.1%比 10.1%),家庭调查中较低(1.5%比 3.5%)。
在一项大规模的多国研究中,我们发现全球有 40%以上的人患有 FGIDs,这会影响生活质量和医疗保健的使用。尽管互联网受访者的绝对患病率较高,但在完成互联网调查和个人访谈的人群中,发现了相似的趋势和相对分布。