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Comparative Study
. 2012;7(8):e43749.
doi: 10.1371/journal.pone.0043749. Epub 2012 Aug 24.

Epidemiology of functional diarrhea and comparison with diarrhea-predominant irritable bowel syndrome: a population-based survey in China

Yan-Fang Zhao  1 , Xiao-Jing Guo, Zhan-Sai Zhang, Xiu-Qiang Ma, Rui Wang, Xiao-Yan Yan, Jia He
Affiliations
Comparative Study

Epidemiology of functional diarrhea and comparison with diarrhea-predominant irritable bowel syndrome: a population-based survey in China

Yan-Fang Zhao et al. PLoS One. 2012.

Abstract

Background: The epidemiology of functional diarrhea and its impacts on Chinese remain unclear, and there are no data on the comparative epidemiology of functional diarrhea and diarrhea-predominant irritable bowel syndrome (IBS-D). This study was to explore the epidemiology of functional diarrhea and its impacts, and to identify its distinction from IBS-D.

Methods and findings: A cross-sectional survey was conducted in 16078 respondents, who were interviewed under a randomized stratified multi-stage sampling design in five cities of China. All respondents completed the modified Rome II questionnaire, and the 36-item Short Form health survey (SF-36) was used for assessing health-related quality of life in 20% of the sample. Overall, 248 respondents (1.54%) had functional diarrhea and 277 (1.72%) had IBS-D. Functional diarrhea was positively associated with increasing age and body mass index (trend test P<0.05). The three most common symptoms for at least 3 weeks in the past months were loose, mushy or watery stools (n = 203, 81.85%), more than three bowel movements a day (n = 100, 40.32%) and having to rush to the toilet to have a bowel movement (n = 72, 29.03%). Meaningful impairment was observed in 5 of the 8 SF-36 domains in respondents with functional diarrhea. The demographics are mostly similar between the respondents with functional diarrhea and IBS-D; however, respondents with IBS-D had more frequent symptoms of diarrhea and even lower scores in SF-36 domains than those with functional diarrhea.

Conclusions: The prevalence of functional diarrhea in China is substantially lower than that in Western countries and relatively higher than that in other Asian countries. It impaired health-related quality of life, and respondents with IBS-D have even worse quality of life. Further population-based studies are needed to investigate the epidemiology of functional diarrhea and the differences between functional diarrhea and IBS-D.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Age- and gender-specific prevalence of functional diarrhea based on a sample of 16078 respondents.
Figure 2
Figure 2. Overlap between the three most common symptoms reported by most respondents in the investigation (n = 248).
Figure 3
Figure 3. Health-related quality of life in individuals with and without functional diarrhea.
Figure 4
Figure 4. Health-related quality of life in individuals with functional diarrhea and with diarrhea-predominant irritable bowel syndrome.
See this image and copyright information in PMC

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