A 13-nation population survey of upper gastrointestinal symptoms: prevalence of symptoms and socioeconomic factors

Haag, Sebastian; Andrews, Jane M.; Gapasin, Judith; Gerken, Guido; Keller, Andreas; Holtmann, Gerald

doi:10.1111/j.1365-2036.2010.04564.x

Cited by 38 publications

(25 citation statements)

References 35 publications

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“…In this context, environmental factors such as specific diets, lifestyle, or hygiene factors at key stages of life may contribute to the manifestation of FGIDs. Indeed, in contrast to IBS, a recent study demonstrated that the prevalence of dyspeptic symptoms was inversely associated with the GDP per capita [7].…”

Section: Early Lifementioning

confidence: 99%

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Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

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Functional gastrointestinal disorders (FGIDs) are common and distressing. They are so named because a defined pathophysiology in terms of structural or biochemical pathways is lacking. Traditionally FGIDs have been conceptualized as brain-gut disorders, with subgroups of patients demonstrating visceral hypersensitivity and motility abnormalities as well as psychological distress. However, it is becoming apparent that there are certain structural or biochemical gut alterations among subsets with the common FGIDs, most notably functional dyspepsia (FD) and irritable bowel syndrome (IBS). For example, a sodium channel mutation has been identified in IBS that may account for 2 % of cases, and subtle intestinal inflammation has been observed in both IBS and FD. Other research has implicated early life events and stress, autoimmune disorders and atopy and infections, the gut microbiome and disordered mucosal immune activation in patients with IBS or FD. Understanding the origin of symptoms in FGIDs will allow therapy to be targeted at the pathophysiological changes, not at merely alleviating symptoms, and holds hope for eventual cure in some cases.For example, there are promising developments in manipulating the microbiome through diet, prebiotics and antibiotics in IBS, and testing and treating patients for Helicobacter pylori infection remains a mainstay of therapy in patients with dyspepsia and this infection. Locally acting drugs such as linaclotide have been an advance in treating the symptoms of constipation-predominant IBS, but do not alter the natural history of the disease. A role for a holistic approach to patients with FGIDs is warranted, as brain-togut and gut-to-brain pathways appear to be activated.

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Section: Early Lifementioning

confidence: 99%

“…In an assessment of more than 23,000 population-based subjects, the prevalence of any uninvestigated dyspepsia was highly variable across various geographic regions, ranging from 24 to 45 % [7]. IBS affects 7-21 % of various populations [8], or around 11 % globally [9].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

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“…The prevalence of upper gastrointestinal symptoms was 44.9% in USA (1) and 38% in European countries. It was highest in Central and East European countries and was closely associated with socioeconomic factors (2).…”

Section: Introductionmentioning

confidence: 99%

The role of diet in the overlap between gastroesophageal reflux disease and functional dyspepsia

Chirilă¹,

Morariu²,

Bărboi³

et al. 2016

Turk J Gastroenterol

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“…Recently, a striking inverse relationship between symptom prevalence and gross domestic product in the respective European countries was observed (Fig. 1) [8]. …”

Section: Pathophysiologic Concepts In Fgidmentioning

confidence: 99%

“…The dataset included 23,164 population-based subjects [8]. The size of the bullets reflects the relative sample size (reproduction with permission).…”

Section: Pathophysiologic Concepts In Fgidmentioning

confidence: 99%

Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview

Holtmann

Shah

Morrison

2017

Dig Dis

142

102

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Background and Summary: Traditionally, functional gastrointestinal disorders (FGID), including functional dyspepsia or irritable bowel syndrome (IBS), are defined by more or less specific symptoms and the absence of structural or biochemical abnormalities that cause these symptoms. This concept is now considered to be outdated; if appropriate tests are applied, structural or biochemical abnormalities that explain or cause the symptoms may be found in many patients. Another feature of FGID are the highly prevalent psychiatric comorbidities, such as depression and anxiety. It is implied that mood disorders “cause” gastrointestinal symptoms. In fact, epidemiological data now provide strong evidence that in subsets of cases, gastrointestinal (GI) symptoms arise first and mood disorders occur later, while in other patients the reverse appears to happen. Possible mechanisms for gut-brain dysfunction have been identified, with systemic minimal inflammation as a causal factor in at least some subjects. Other mechanisms that play a role in FGID include chronic infections, intestinal microbiota, low-grade mucosal inflammation including the increase of eosinophils, systemic immune activation, altered intestinal permeability, in diarrhea predominant IBS altered bile salt metabolism, abnormalities in the serotonin metabolism and genetic factors. All these factors might be modulated by environmental factors such as diet. Key Messages: While a number of factors can be linked to specific symptoms (e.g., pain or diarrhea), it is evident that the symptom-based categorization of patients will not allow targeted treatments that specifically address the underlying pathophysiology.

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A 13-nation population survey of upper gastrointestinal symptoms: prevalence of symptoms and socioeconomic factors

Cited by 38 publications

References 35 publications

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

The role of diet in the overlap between gastroesophageal reflux disease and functional dyspepsia

Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview

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