Psychological illness is commonly associated with functional gastrointestinal disorders and is important to consider during patient consultation: a population-based study

Abstract

Background: Some individuals with functional gastrointestinal disorders (FGID) suffer long-lasting symptoms without ever consulting their doctors. Our aim was to study co-morbidity and lifestyle differences among consulters and non-consulters with persistent FGID and controls in a defined adult population.

Methods: A random sample of the general adult Swedish population was obtained by a postal questionnaire. The Abdominal Symptom Questionnaire (ASQ) was used to measure GI symptomatology and grade of GI symptom severity and the Complaint Score Questionnaire (CSQ) was used to measure general symptoms. Subjects were then grouped for study by their symptomatic profiles. Subjects with long-standing FGID (n = 141) and subjects strictly free from gastrointestinal (GI) symptoms (n = 97) were invited to attend their local health centers for further assessment.

Results: Subjects with FGID have a higher risk of psychological illness [OR 8.4, CI95(4.0-17.5)] than somatic illness [OR 2.8, CI95(1.3-5.7)] or ache and fatigue symptoms [OR 4.3, CI95(2.1-8.7)]. Subjects with psychological illness have a higher risk of severe GI symptoms than controls; moreover they have a greater chance of being consulters. Patients with FGID have more severe GI symptoms than non-patients.

Conclusion: There is a strong relation between extra-intestinal, mental and somatic complaints and FGID in both patients and non-patients. Psychological illness increases the chance of concomitantly having more severe GI symptoms, which also enhance consultation behaviour.

Figure 1

Sampling procedure of the Gastrointestinal Consult Study (GiCon study). Sampling procedure of the Gastrointestinal Consult Study (GiCon study) with relation to the prior study of 1995.

Figure 2

GI symptoms, pain modalities and location. The symptoms inquired are shown in Part 1, and the pain and discomfort modalities with the master sketch for indicating their abdominal location in Part 2. The asterisks are explained in the text. Swedish laymen terms were used in the questionnaire. The master sketch shows the eligible pain locations.

Figure 3

Proportion of subjects with FGID and with SSF reporting complaints during the previous three months in the CSQ. Proportions (0–1.0) of subjects with FGID and with SSF (n = 238) reporting complaints during the previous three months in the Complaint Score Questionnaire (CSQ). There were significance differences *(p < 0.0016) on an age and sex adjusted logistic regression for all variables except coughing (ns) and excessive weight (ns).

Figure 4

Proportion of complaints from the Complaint Score Questionnaire among those with FGID, divided into Consulters and Non-Consulters. Proportion (0–1.0) of complaints from the Complaint Score Questionnaire (CSQ) among those with FGID, divided into Consulters and Non-Consulters (n = 141). None of the variables showed a significant difference between Consulters and Non-Consulters for P values less than 0.0016, tested by a sex and age adjusted logistic regression.