Academic Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK.
Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina, USA.
United European Gastroenterol J. 2022 Sep;10(7):736-744. doi: 10.1002/ueg2.12271. Epub 2022 Jul 3.
To determine the population prevalence and associated health impairment of disorders of gut-brain interaction (DGBI) across Great Britain, and the emphasis placed upon them within medical education.
An Internet-based cross-sectional health survey was completed by 1906 general population adults across Great Britain without self-reported organic GI disease. The survey enquired for demographics, symptom-based criteria for Rome IV DGBI, healthcare use, non-GI somatic symptoms, and quality of life. As a separate analysis, we evaluated which DGBI are considered core knowledge at undergraduate medical school level and post-graduate specialization level for Gastroenterologists and General Practitioners.
The overall prevalence of DGBI across Great Britain was 37%, being similar for England (37%), Scotland (33%), and Wales (36%); p = 0.66. There was no difference between English regions (range 33%-43%, p = 0.26). The prevalence of DGBI was highest in those aged 18-40 years (40%), then 40-64 years (37%), and least amongst those ≥65 years (29%); p < 0.001. The most common DGBI were bowel disorders (30%), followed by gastroduodenal (10.5%), anorectal (8.1%) and oesophageal disorders (6.2%). Individuals with DGBI were significantly more likely than those without DGBI to have increased GI-related healthcare visits, medication use, surgical interventions, non-GI somatic symptoms, and reduced quality of life. One-in-three people with DGBI had multiple GI organ regions involved and this correlated with increased health impairment (p < 0.001). The only DGBI mentioned across all medical training curricula is irritable bowel syndrome, while the General Practitioner and Gastroenterology Curricula also recognise the outdated term non-ulcer dyspepsia (as opposed to functional dyspepsia). The 2010 Gastroenterology Curriculum also includes functional constipation and disordered defecation, with the incoming 2022 iteration adding in functional upper GI syndromes, functional abdominal pain, and opioid-induced GI disturbances.
Disorders of gut-brain interaction are common across Great Britain and incur substantial health impairment. However, they are generally under-taught within the British medical education system. Increasing awareness and education of disorders of gut-brain interaction might improve patient outcomes.
本研究旨在明确英国各地肠-脑交互障碍（DGBI）的人群患病率及其相关健康损害，并评估其在医学教育中的重视程度。
本项基于互联网的横断面健康调查在英国的 1906 名无自述器质性胃肠道疾病的普通成年人群中完成。调查内容包括人口统计学信息、罗马 IV 版 DGBI 的基于症状的标准、医疗保健利用情况、非胃肠道躯体症状和生活质量。作为一项单独的分析，我们评估了哪些 DGBI 被认为是本科医学教育和胃肠病学家及全科医生研究生专业水平的核心知识。
在英国，总体 DGBI 患病率为 37%，英格兰（37%）、苏格兰（33%）和威尔士（36%）的患病率相当（p=0.66）；英格兰各地区之间无差异（范围 33%-43%，p=0.26）。DGBI 患病率在 18-40 岁人群中最高（40%），其次是 40-64 岁人群（37%），而≥65 岁人群最低（29%）（p<0.001）。最常见的 DGBI 是肠功能障碍（30%），其次是胃十二指肠疾病（10.5%）、肛门直肠疾病（8.1%）和食管疾病（6.2%）。与无 DGBI 者相比，DGBI 患者更有可能增加胃肠道相关的医疗就诊、药物使用、手术干预、非胃肠道躯体症状和生活质量下降（p<0.001）。三分之一的 DGBI 患者有多个胃肠道器官受累，这与更严重的健康损害相关（p<0.001）。在所有医学培训课程中仅提到一种 DGBI，即肠易激综合征，而全科医生和胃肠病学课程还承认过时的术语非溃疡性消化不良（而非功能性消化不良）。2010 年的胃肠病学课程还包括功能性便秘和排便障碍，即将推出的 2022 年版本增加了功能性上胃肠道综合征、功能性腹痛和阿片类药物引起的胃肠道紊乱。
肠-脑交互障碍在英国很常见，且会导致严重的健康损害。然而，它们在英国医学教育系统中通常未得到充分教授。提高对肠-脑交互障碍的认识和教育可能会改善患者的结局。
