Anxiety and Depression Increase in a Stepwise Manner in Parallel With Multiple FGIDs and Symptom Severity and Frequency

Sánchez, María Inés Pinto; Ford, Alexander C; Avila, Christian; Verdú, Elena F.; Collins, Stephen M.; Morgan, David; Martin, Paul; Berčík, Přemysl

doi:10.1038/ajg.2015.128

Cited by 116 publications

(114 citation statements)

References 59 publications

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“…Given the high prevalence of psychological comorbidity in FGID patients, 3 it might be anticipated that psychological therapies will have an important therapeutic role in these conditions. This underappreciation of psychological comorbidity in FGIDs has been reported previously 44 and is likely to be widespread. This underappreciation of psychological comorbidity in FGIDs has been reported previously 44 and is likely to be widespread.…”

Section: Discussionsupporting

confidence: 58%

Delivery of care for functional gastrointestinal disorders: A systematic review

Basnayake

Kamm

Salzberg

et al. 2019

J of Gastro and Hepatol

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Background A diverse range of treatments are available for the treatment of functional gastrointestinal disorders (FGIDs). Individual treatments, including drug therapies, behavioral therapy (“biofeedback”), psychological therapies, and dietary therapies, have been well validated in controlled, randomized trials and real‐life case series. However, few studies have evaluated models of delivery of care for the whole population of referred patients with an FGID. This review evaluates models of specialist outpatient care for the management of FGIDs. Methods A systematic review was performed of full‐text articles published until October 2018 in Pubmed/Medline and Embase. Studies were included if they evaluated a model of outpatient care in a specialist setting for the treatment of adult patients with an FGID and included patient‐reported outcomes comprising symptoms, quality of life, or psychological well‐being. Results Few studies have evaluated the delivery of care for the whole population of referred patients with an FGID, and there was one randomized comparison of different models of care. Two studies that evaluated the outcome of gastroenterologist‐only clinics suggested poor long‐term results. Two non‐comparative case series reported the outcome of multidisciplinary care, including gastroenterologists and psychological therapists, suggesting improved patient quality of life and psychological well‐being. Conclusions Despite the high prevalence and cost of treating FGIDs, and the availability of effective treatments, there are few data and limited randomized comparisons reporting the outcome of different types of specialist care. The few data available suggest that multidisciplinary care is superior to gastroenterologist‐only care, but this needs to be validated in prospective comparative studies.

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Section: Discussionsupporting

confidence: 58%

Delivery of care for functional gastrointestinal disorders: A systematic review

Basnayake

Kamm

Salzberg

et al. 2019

J of Gastro and Hepatol

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“…This study showed that demographic characteristics of FGIDs including younger age, and being female were more likely to be associated with overlap or having more than one FGID, compared to subjects with only one FGID or controls. Gender differences in some FGIDs, most notably in IBS, are well established . Other unexplained disorders including fibromyalgia and 0chronic fatigue syndrome are also more prevalent in women than in men.…”

Section: Discussionmentioning

confidence: 99%

“…Our population‐based data support the concept that a brain‐gut disorder (as identified by somatization) characterizes a substantial proportion of those with FGIDs and is likely often integral to the disease experience. Recently, Pinto‐Sanchez et al . demonstrated that the prevalence of anxiety and depression increased in a stepwise manner with the number of co‐existing FGIDs and/or frequency and/or severity of GI symptoms.…”

Section: Discussionmentioning

confidence: 99%

Multiple functional gastrointestinal disorders linked to gastroesophageal reflux and somatization: A population‐based study

Choung

Locke

Schleck

et al. 2017

Neurogastroenterology Motil

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Background It is unknown why functional gastrointestinal disorders (FGIDs) overlap and limited information exists on risk factors for those with overlap. Our aim was to estimate the prevalence of combinations of FGIDs including reflux (FGIDs-GER), and evaluate potential risk factors for people with multiple disorders in a representative US community. Methods A population-based study was conducted by mailing a valid GI symptom questionnaire to an age- and gender- stratified random sample of residents of Olmsted County, MN. Rome III definitions were used to identify people with FGIDs, and GER was defined by weekly or more frequent heartburn or acid regurgitation. The prevalence of people meeting multiple symptom complexes was estimated. Moreover, potential risk factors for people with multiple disorders were evaluated. Key Results A total of 3548 people provided data for each of the necessary symptom questions (mean age: 61 years ± 16, 54% female). Among these 3548 subjects, 2009 (57%) had no FGIDs-GER, 906 (26%) had a pure FGID-GER, 372 (10%) had 2 FGIDs-GER, and 261 (7%) had 3 or more FGIDs-GER. Somatization as assessed by a higher somatic symptom checklist score (OR=3.3, 95% CI [2.7,4.1]) was associated with an increased odds for those with 3 or more FGIDs-GER compared to subjects with a pure FGID-GER adjusting for age and gender. Conclusions & Inferences Symptom complex overlap is common rather than rare in the community. GER is an integral symptom complex associated with both upper and lower FGIDs. Somatization is a strong risk factor for multiple FGIDs.

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“…Although there is no impact of IBS on mortality, it is likely that the morbidity associated with its chronic nature and the high incidence of GI and extra-intestinal comorbidities, such as anxiety and depression,5 contribute to its negative impact on health-related quality of life 6 7. IBS results in considerable healthcare utilisation, with 30% of consultations in primary care relating to gastroenterology,8 up to 60% of referrals to gastroenterology in secondary care9 being due to IBS, and annual national healthcare costs related to IBS totalling £45–£200 million in the UK10 and $1.66 billion in the USA 11.…”

Section: Introductionmentioning

confidence: 99%

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

272

236

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There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production that, in those with visceral hypersensitivity, induces functional GI symptoms. Dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet) is now increasingly used in the clinical setting. Initial research evaluating the efficacy of the low FODMAP diet was limited by retrospective study design and lack of comparator groups, but more recently well-designed clinical trials have been published. There are currently at least 10 randomised controlled trials or randomised comparative trials showing the low FODMAP diet leads to clinical response in 50%-80% of patients with IBS, in particular with improvements in bloating, flatulence, diarrhoea and global symptoms. However, in conjunction with the beneficial clinical impact, recent studies have also demonstrated that the low FODMAP diet leads to profound changes in the microbiota and metabolome, the duration and clinical relevance of which are as yet unknown. This review aims to present recent advances in the understanding of the mechanisms by which the low FODMAP diet impacts on symptoms in IBS, recent evidence for its efficacy, current findings regarding the consequences of the diet on the microbiome and recommendations for areas for future research.

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Anxiety and Depression Increase in a Stepwise Manner in Parallel With Multiple FGIDs and Symptom Severity and Frequency

Cited by 116 publications

References 59 publications

Delivery of care for functional gastrointestinal disorders: A systematic review

Delivery of care for functional gastrointestinal disorders: A systematic review

Multiple functional gastrointestinal disorders linked to gastroesophageal reflux and somatization: A population‐based study

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

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