TOPLINE:

Functional bowel disorders (FBDs) affect 33.2% of adults worldwide, with similar rates across regions and are linked to increased nongastrointestinal (non-GI) and psychological symptoms, impaired quality of life, and higher healthcare utilization.

METHODOLOGY:

• FBDs are common and associated with significant quality-of-life impairment and healthcare use, but prior studies largely focused on irritable bowel syndrome (IBS) or limited populations.
• Researchers analyzed internet survey data from 26 countries to determine global or regional prevalences and characteristics of FBDs.
• Participants completed the full Rome IV Adult Diagnostic Questionnaire and an 80-item supplemental survey covering demographics, healthcare utilization, and medical history.
• Analyses assessed the prevalence of FBDs, most bothersome bowel symptoms, non-GI somatic and psychological symptoms (including anxiety and depression), quality of life, and healthcare utilization.
• IBS prevalence using Rome III and Rome IV criteria were compared; the Rome III questionnaire included participants from 14 countries.

TAKEAWAY:

• Among 54,127 respondents, 33.2% had FBDs, with functional constipation most common (11.7%), followed by unspecified FBD (8.7%). Prevalence rates had minimal variations across regions.
• Individuals with FBDs reported more severe non-GI somatic symptoms, more frequent psychological symptoms, lower quality of life, and greater healthcare utilization than those without FBDs. These burdens were highest in participants with IBS and opioid-induced constipation.
• In unspecified FBD, altered bowel habits were most common (constipation, 59%; diarrhea, 35%), followed by weekly bloating (14.8%) and abdominal pain (6.5%). Abdominal pain was associated with the greatest symptom burden and healthcare utilization.
• IBS prevalence decreased from 10.1% under Rome III to 4.1% under Rome IV criteria, reflecting the latter’s higher symptom frequency threshold.

IN PRACTICE:

“These findings can be of importance in future iterations of diagnostic criteria for FBD, one of the most common groups of GI diagnoses worldwide,” the authors wrote.

SOURCE:

This study was led by Navkiran Thind Tornkvist, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. It was published online in the American Journal of Gastroenterology.

LIMITATIONS: 

The cross-sectional design precluded causal inference. Clinical evaluations were not performed to rule out organic disease.

DISCLOSURES:

This study received support from the Swedish state under the ALF agreement, the Swedish Research Council, and unrestricted grants from Ironwood, Shire, Allergan, and Takeda for RFGES. Several authors reported receiving research contracts or personal fees from or being on the advisory boards of various pharmaceutical, biotechnology, and healthcare companies and the Rome Foundation.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.