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United European Gastroenterol J. 2016 Jun;4(3):413-22. doi: 10.1177/2050640615600114. Epub 2015 Aug 06.

Symptom burden and consulting behavior in patients with overlapping functional disorders in the US population.

United European gastroenterology journal

Nimish Vakil, Margie Stelwagon, Elizabeth P Shea, Steve Miller

Affiliations

  1. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  2. Ironwood Pharmaceuticals, Cambridge MA, USA.
  3. Lieberman Inc, Great Neck, NY, USA.

PMID: 27403308 PMCID: PMC4924424 DOI: 10.1177/2050640615600114

Abstract

BACKGROUND: Regulatory and treatment guidelines focus on individual conditions, yet clinicians often see patients with overlapping conditions.

OBJECTIVE: This cross-sectional survey study assesses the impact of overlapping functional dyspepsia (FD), gastroesophageal reflux disease (GERD), irritable bowel syndrome with constipation (IBS-C), and chronic idiopathic constipation (CIC) on symptom burden and consulting behavior.

METHODS: Survey participants met Rome III criteria for FD, IBS-C, and/or CIC, and/or reported GERD; participants answered questions about symptom frequency and bothersomeness, work and productivity, and consulting behavior.

RESULTS: Of 2641 respondents, 1592 (60.3%) had one condition; 832 (31.5%) had two; and 217 (8.2%) had three; 57.3% of 1690 FD, 54.6% of 1337 GERD, 82.6% of 328 IBS-C, and 62.5% of 552 CIC respondents had condition overlap. Overall GI symptoms were very/extremely bothersome in 28.6% of single-condition respondents, 50.7% of two-condition, and 69.6% of three-condition respondents (pā€‰<ā€‰0.001, chi square). Symptom frequency and productivity losses both increased with condition overlap. Over 12 months, 43.7% of single-condition, 49.9% of two-condition, and 66.5% of three-condition respondents consulted a physician about GI symptoms (pā€‰<ā€‰0.001, chi square).

CONCLUSION: Functional GI disorders frequently overlap with each other and with GERD. Condition overlap is associated with greater symptom burden and increased physician consultations.

Keywords: FD; GERD; IBS; IBS-C; Irritable bowel syndrome with constipation; chronic idiopathic constipation; functional dyspepsia; gastroesophageal reflux disease

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