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. 2022 Sep;10(7):736-744.
doi: 10.1002/ueg2.12271. Epub 2022 Jul 3.

Disorders of gut-brain interaction: Highly prevalent and burdensome yet under-taught within medical education

Julia Simons  1 , Umair Shajee  1 , Olafur Palsson  2 , Magnus Simren  2   3 , Ami D Sperber  4 , Hans Törnblom  3 , William Whitehead  2 , Imran Aziz  1   5
Affiliations

Disorders of gut-brain interaction: Highly prevalent and burdensome yet under-taught within medical education

Julia Simons et al. United European Gastroenterol J. 2022 Sep.

Abstract

Background and objective: To determine the population prevalence and associated health impairment of disorders of gut-brain interaction (DGBI) across Great Britain, and the emphasis placed upon them within medical education.

Methods: An Internet-based cross-sectional health survey was completed by 1906 general population adults across Great Britain without self-reported organic GI disease. The survey enquired for demographics, symptom-based criteria for Rome IV DGBI, healthcare use, non-GI somatic symptoms, and quality of life. As a separate analysis, we evaluated which DGBI are considered core knowledge at undergraduate medical school level and post-graduate specialization level for Gastroenterologists and General Practitioners.

Results: The overall prevalence of DGBI across Great Britain was 37%, being similar for England (37%), Scotland (33%), and Wales (36%); p = 0.66. There was no difference between English regions (range 33%-43%, p = 0.26). The prevalence of DGBI was highest in those aged 18-40 years (40%), then 40-64 years (37%), and least amongst those ≥65 years (29%); p < 0.001. The most common DGBI were bowel disorders (30%), followed by gastroduodenal (10.5%), anorectal (8.1%) and oesophageal disorders (6.2%). Individuals with DGBI were significantly more likely than those without DGBI to have increased GI-related healthcare visits, medication use, surgical interventions, non-GI somatic symptoms, and reduced quality of life. One-in-three people with DGBI had multiple GI organ regions involved and this correlated with increased health impairment (p < 0.001). The only DGBI mentioned across all medical training curricula is irritable bowel syndrome, while the General Practitioner and Gastroenterology Curricula also recognise the outdated term non-ulcer dyspepsia (as opposed to functional dyspepsia). The 2010 Gastroenterology Curriculum also includes functional constipation and disordered defecation, with the incoming 2022 iteration adding in functional upper GI syndromes, functional abdominal pain, and opioid-induced GI disturbances.

Conclusion: Disorders of gut-brain interaction are common across Great Britain and incur substantial health impairment. However, they are generally under-taught within the British medical education system. Increasing awareness and education of disorders of gut-brain interaction might improve patient outcomes.

Keywords: DGBI; FGID; IBS; constipation; disorders of gut-brain interaction; functional gastrointestinal disorders; irritable bowel syndrome; motility; motility disorders.

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Conflict of interest statement

MS has received unrestricted research grants from Danone Nutricia Research and Glycom and served as a Consultant/Advisory Board member or speaker for Biocodex, Danone Nutricia Research, Ironwood, Genetic Analysis AS, Glycom, Tillotts, Menarini, Takeda, Kyowa Kirin, Arena, Adnovate, Alimentary Health, AlfaSigma, Falk Foundation and Shire. HT has served as Consultant/Advisory Board member for Almirall and Shire. OSP has received salary support from a research grants from Takeda Pharmaceuticals, Salix Pharmaceuticals and the Rome Foundation, from a consulting agreement with Glycom A/S, Ironwood Pharmaceuticals and an educational grant provided by Takeda Pharmaceuticals, and received a speaker honorarium in educational programmes supported by Ironwood Pharmaceuticals, Takeda Pharmaceuticals and the Rome Foundation. WEW received research grants from Takeda, Ironwood, Salix, and the Rome Foundation; served as a consultant to Biomerica USA, Ono Pharmaceuticals and Ferring; and received unrestricted educational grants from Takeda and Ferring. ADS has served as a consultant and speaker for Takeda‐Israel and has received a research grant from them and as a consultant for Abbvie‐Israel. JS, SU, and IA have no declarations.

Figures

FIGURE 1
FIGURE 1
Prevalence of disorders of gut‐brain interaction (DGBI) across Great Britain
FIGURE 2
FIGURE 2
Prevalence of disorders of gut‐brain interaction (DGBI) according to age group
See this image and copyright information in PMC

References

    1. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016;150(6):1262–79. - PubMed
    1. Drossman DA, Hasler WL. Rome IV‐functional GI disorders: disorders of gut‐brain interaction. Gastroenterology. 2016;150(6):1257–61. - PubMed
    1. Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome foundation global study. Gastroenterology. 2021;160(1):99–114.e113. - PubMed
    1. Thompson WG, Heaton KW, Smyth GT, Smyth C. Irritable bowel syndrome in general practice: prevalence, characteristics, and referral. Gut. 2000;46(1):78–82. - PMC - PubMed
    1. Lacy BE, Ford AC, Talley NJ. Quality of care and the irritable bowel syndrome: is now the time to set standards? Am J Gastroenterol. 2018;113(2):167–9. - PubMed

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