Burden of Gastrointestinal Symptoms in the United States: Results of a Nationally Representative Survey of Over 71,000 Americans

Abstract

OBJECTIVES: Digestive diseases account for over 100 million ambulatory care visits annually in the U.S. Yet, comparatively less is known about the true burden of gastrointestinal (GI) symptoms in the general U.S. population. The aim of this study was to use data from the “National GI Survey” – a population-based audit of GI symptoms in over 71,000 participants – to determine the prevalence and predictors of GI symptoms in community-dwelling Americans. METHODS: We conducted the National GI Survey using a mobile app called MyGiHealth which employs a computer algorithm that systematically collects participants’ GI symptoms. We recruited a nationally representative sample of Americans to complete the survey, which guided respondents through National Institutes of Health (NIH) GI Patient Reported Outcome Measurement Information System (PROMIS®) scales along with questions about relevant comorbidities and demographics. We measured the prevalence of GI symptoms in the past week and employed logistic regression to adjust for confounding. RESULTS: Overall, 71,812 individuals completed the survey, of which 61% reported having had ≥1 GI symptom in the past week. The most commonly reported symptoms were heartburn/reflux (30.9%), abdominal pain (24.8%), bloating (20.6%), diarrhea (20.2%), and constipation (19.7%). Less common symptoms were nausea/vomiting (9.5%), dysphagia (5.8%), and bowel incontinence (4.8%). Females, non-Hispanic whites, and individuals who were younger, highly educated, and had medical comorbidities were more likely to have symptoms (all adjusted p<.05). CONCLUSIONS: In this large population-based study that combined digital health technology with NIH PROMIS questionnaires, we found that GI symptoms are highly prevalent, as nearly two-thirds of surveyed Americans are burdened by these symptoms.

“Dr. Google, I am in Pain”—Global Internet Searches Associated with Pain: A Retrospective Analysis of Google Trends Data

“…In a recent large population-based study that combined digital health technology with questionnaires, Almatio et al found that GI symptoms were highly prevalent among the 71,000 surveyed US citizens. Nearly 25% of the responders had experienced Abdominal pain in the past week [31]. In contrast to Headache (migraine), Back pain, and Neck pain, the causes of Abdominal pain are not in the top ten main causes of years of life in disability [4].…”

Analysis of Answers to Queries among Anonymous Users with Gastroenterological Problems on an Internet Forum

“…Ziółkowski et al reported that the most common abdominal symptoms in a middle-sized Polish city are heartburn/reflux (36%), bloating (31%), dyspepsia (23%) and constipation (13%) [25]. In a large US study, the most prevalent symptoms in the general population were heartburn/reflux (31%), abdominal pain (25%), bloating (21%), diarrhea (20%), constipation (20%) and nausea/vomiting (10%) [26]. The prevalence of symptoms declared by forum users partially reflects the real-world prevalence.…”

Classification of gastrointestinal symptom patterns in young adults

“…A study within a general US adult population (n = 71, 812, ages 18-65) used the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System GI scales (PROMIS-GI) to evaluate the prevalence of eight overarching GI symptom domains: abdominal pain, bloating/gas, bowel incontinence, constipation, diarrhea, swallowing, reflux, and nausea/vomiting [6]. Sixty-one percent of their sample endorsed at least one symptom within the past 7 days.…”