Risk factors of bloating and its association with common gastrointestinal disorders in a sample of Iranian adults

Abstract

Background/Aims: Bloating is an unpleasant but common gastrointestinal symptom that is experienced by many people at some stage in their lives. The current survey was conducted to investigate the epidemiology and risk factors of bloating and functional bloating (FB). In addition, we aimed to assess the association between bloating and functional gastrointestinal disorders (FGIDs). Materials and Methods: In this cross-sectional study, the self-administered modified Rome III questionnaire was used to assess gastrointestinal symptoms and FGIDs. Severity of bloating, demographic and anthropometric measurements, physical activity level, psychological distress, and depression and anxiety were also assessed. Results: Among the 4763 participants, 52.9% reported having experienced bloating at least occasionally in the past three months (among which 14.1% had severe or very severe symptoms); 19.7% of subjects were found to have FB. After adjusting for multiple variables, female gender, university degree, obesity, and anxiety were associated with both bloating and FB, while depression and psychological distress were only associated with bloating. The positive predictive value and negative predictive value of bloating for the diagnosis of functional bowel disorder were 92.9% and 80.1%, respectively. Conclusion: Bloating and FB are highly prevalent in the study population. We also identified several demographic, psychological, and lifestyle-related risk factors of bloating in this population. Keywords: Bloating, functional bloating, functional gastrointestinal disorders, Iran, epidemiology Original Article retention, weak anterior wall muscle tone, abnormal gut microflora, inflammation, and altered bowel tonic and phasic motility, none of these has been scientifically proven (3,14). However, studies have shown both increased intestinal gas accumulation and delayed gas transit to be important causes of bloating. Distorted perception and visceral hyperalgesia may also play a role in some patients (2,3,5,14).Physical exercise accelerates gut transit and thus reduces bloating; however, studies on healthy subjects found that physical activity accelerated gas transit but did not affect bloating. The relationship between physical activity and bloating remains unclear (5). Obesity is also an established risk factor for FGIDs; however, data regarding its effects on bloating contain discrepancies (14). Psychological therapies have also been found to be useful in improving bloating and several other FGIDs; however, it remains unclear whether an actual relationship exists between bloating and psychosocial distress (2). Studies have also evaluated the associations of bloating with smoking, marital status, age, and education level (4,5,7); however, data confirming the associations of these variables is limited.The prevalence of bloating, as a symptom, is dramatically higher in subjects who suffer from other FGIDs, notably irritable bowel syndrome (IBS) (4). Studies have shown that more than two thirds of IBS patients may complain ...

Epidemiology of Gastroesophageal Reflux Disease in Iran: A Systematic Review and Meta-analysis

“…However, in a more recent systematic review in 2011, the weekly prevalence of GERD was reported to be 8. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].9% in Europe and 18.1-27.8% in North America and 2.5-7.8% in East Asia (50). Therefore, the global prevalence of GERD is increasing over time (50).…”