Cultural Factors Influencing Functional Gastrointestinal Disorders in the East

Abstract

Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functional gastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptom presentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functional dyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.

The association of body mass index with functional dyspepsia is independent of psychological morbidity: A cross-sectional study

“…Secondly, differences in BMI criteria are well recognised between Asians and Caucasians [ 29 ]. Thirdly, cultural factors in different geographical regions have been shown to influence FGID characteristics and may have contributed to the variation in the association of BMI and FGIDs [ 30 ].…”

Gastrointestinal Disorders and Metabolic Syndrome: Dysbiosis as a Key Link and Common Bioactive Dietary Components Useful for their Treatment

“…The health of the digestive system is important for its appropriate physiological functions, where said physiological parameters largely depend on the type of food ingested and the presence of bioactive components therein [ 57 ]. The major factors associated with the development of GI disorders are the use of medications for the treatment of chronic disorders [ 58 ], cultural attitudes [ 59 ], and socioeconomic factors [ 60 ]. The undesirable effects of drugs used for the treatment of GI disorders have led scientists and clinicians to focus on the use of alternative options.…”

Prevalence of Subthreshold Depression Among Constipation-Predominant Irritable Bowel Syndrome Patients

“…Sub-analysis of five separate studies showed that depression was found to be the highest among IBS-C compared to diarrhea-predominant (IBS-D) and mixed-type IBS (IBS-M) (Lee et al, 2017). Cultural habits and language were spotted to be responsible for the differences in symptoms' interpretation of IBS in the Eastern countries (Chuah and Mahadeva, 2018). Moreover, dietary practices in terms of fiber intake influenced the prevalence of functional constipation between Eastern and Western countries (Chuah and Mahadeva, 2018).…”

“…Cultural habits and language were spotted to be responsible for the differences in symptoms' interpretation of IBS in the Eastern countries (Chuah and Mahadeva, 2018). Moreover, dietary practices in terms of fiber intake influenced the prevalence of functional constipation between Eastern and Western countries (Chuah and Mahadeva, 2018). The pathophysiology of IBS is complex and remains inadequately understood, but it is most likely due to complex interactions between the nervous system, immune changes and hormonal dysregulation (Nam et al, 2010;Fichna and Storr, 2012;Stasi et al, 2012).…”