Overlap of heartburn, functional dyspepsia, and irritable bowel syndrome in a population sample: Prevalence, temporal stability, and associated comorbidities

Abstract

Background: Co-occurring (overlapping) irritable bowel syndrome (IBS), functional dyspepsia (FD), and heartburn has been observed. However, whether it is a distinct entity has not been established, nor what clinical, demographic, lifestyle, and psychological traits are associated with it. This study sought to estimate the prevalence and temporal stability of this overlap and to identify features specific to it in order to gain some insights into the potential etiopathogenesis.Methods: Two waves of a survey to a population-representative sample were conducted 3 years apart, recruiting 1312 individuals for this study. The chanceexpected probability of complete overlap (CO) was calculated and compared with the observed CO. A range of demographic, lifestyle factors, medical diagnoses, sleep quality, and psychological distress were tested to identify predictors of overlap using logistic regression. Key Results: CO was observed in 2.1% (95% confidence interval 1.9, 3.7) of the sample and was closely replicated in wave 2 at 2.0%. The observed CO was greater than expected by chance (0.2%) to a statistically significant extent (p < 0.001). Overlap between IBS subtypes, FD subtypes, and heartburn was also elevated above chance expectation. Individuals with CO were separately differentiated from others with respect to elevated rates of self-reported medically diagnosed asthma, elevated psychological distress score, and elevated impact on sleep quality. The discrimination provided by these factors was further independent of age and sex. Conclusions and Inferences: Overlap between IBS, FD, and heartburn (GERD)appears to be a distinct entity that has a profile including psychological morbidity, sleep disturbance, and elevated rates of atopy.

Association of mental health conditions and functional gastrointestinal disorders among Vietnamese new-entry medical students

“…Jones et al . found that 2% of an Australian random community sample met the criteria for overlap GERD-FD-IBS, which was estimated to be twenty-fold greater than the expected probability by random chance [ 24 ]. Although the prevalences of OS in Asian countries are generally lower than in Western countries, these findings confirm that OS in the general population is common and does not occur by chance.…”

Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment

“…Interestingly, an Australian study showed no relationship between gender and overlap[ 25 , 28 ]. There seems to be a distinct overlap between IBS, FD, and gastroesophageal reflux disease (GERD), in which it is easier to merge psychological morbidity and sleep disturbance[ 29 ]. Although age, gender, and IBS subtype were not correlated with overlap[ 25 ], the pathogenesis analysis of IBS and FD indicates that psychological factors are linked to the overlap of IBS and FD.…”

Research trends in the field of the gut-brain interaction: Functional dyspepsia in the spotlight – An integrated bibliometric and science mapping approach

“…Further, FD patients can also exhibit certain overlaps with GERD and IBS, and are, therefore, often misclassified ( Quigley and Lacy, 2013 ; Pleyer et al, 2014 ; von Wulffen et al, 2019 ). Compared to patients with single FGID, those with overlap syndrome visit the hospital more frequently and report more frequent and severe gastrointestinal symptoms, more severe depression, as well as lower QOL ( Lee et al, 2020 ; Barberio et al, 2022 ; Jones et al, 2022 ). FGID overlap syndrome is often explained by diseases sharing the same pathophysiology (such as visceral hypersensitivity and gastrointestinal motility disorder) occurring in multiple organs instead of being confined to one gastrointestinal segment.…”