Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Clin Gastroenterol Hepatol. 2022 May;20(5):e945-e956. doi: 10.1016/j.cgh.2021.05.042. Epub 2021 May 27.
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.
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.
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.
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.
肠易激综合征（IBS）、功能性消化不良和功能性便秘等疾病均属于胃肠道（GI）功能障碍，这些疾病被归类为肠-脑相互作用障碍（DGBI），可对患者的生活造成负面影响。本研究旨在评估在大规模全球人群中 DGBI 的重叠程度和后果。
对来自 26 个国家的 54127 名成年人（49.1%为女性）的互联网调查数据进行分析，研究范围涵盖 4 个 GI 解剖区域（食管、胃十二指肠、肠道和肛门直肠）。评估 DGBI 受累的 GI 区域数量，并分析其与性别、年龄、疾病严重程度、生活质量、心理社会变量和卫生保健利用之间的关系。
共有 40.3%的调查对象符合罗马 IV 标准的 DGBI。1-4 个 DGBI 受累的 GI 区域的百分比分别为 68.3%、22.3%、7.1%和 2.3%。IBS 症状严重程度评分从 1 个区域（207.6）显著增加至 4 个区域（291.6），非 GI 症状报告（躯体化）、焦虑和抑郁、对肠道功能的关注和尴尬、就诊次数、药物治疗和腹部手术均显著增加（均 P <.0001）。随着 DGBI 区域数量的增加，生活质量逐渐下降（P <.0001）。在逻辑混合模型中，非 GI 症状（比值比 [OR]，1.09；95%置信区间 [CI]，1.08-1.10）、非常关注与不关注（OR，2.55；95% CI，2.27-2.90）、非常尴尬与不尴尬（OR，1.20；95% CI，1.08-1.33）和平均就诊次数（OR，1.23；95% CI，1.115-1.32）与 DGBI 区域数量的相关性最强。
多个 GI 区域的 DGBI 与心理合并症、卫生保健利用和 IBS 严重程度增加有关。医生对重叠的认识可以改善医疗质量，避免不必要的干预，并带来更积极的健康结果。
