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Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population
  1. N J Talleya,
  2. P Boyceb,
  3. M Jonesa
  1. aDepartment of Medicine, University of Sydney, Australia, bDepartment of Psychological Medicine
  1. Dr N J Talley, Professor of Medicine, Department of Medicine, University of Sydney, Clinical Sciences Building, Nepean Hospital, Penrith, NSW, Australia 2751.

Abstract

Background—The current classification dividing patients with functional gastrointestinal symptoms into subgroups remains controversial.

Aims—To determine whether distinct symptom groupings exist in the community.

Methods—A random sample of Sydney residents in Penrith, Australia was mailed a validated self report questionnaire. Gastrointestinal symptoms including the Rome criteria for irritable bowel syndrome (IBS) and dyspepsia were measured.

Results—Among 730 respondents, the 12 month age and gender adjusted prevalence (adjusted to the Australian population) of IBS, dyspepsia, and gastro-oesophageal reflux were 11.8% (95% confidence interval (CI) 9.3 to 14.3%), 11.5% (95% CI 9.6 to 14.6%), and 17.5% (95% CI 14.2 to 19.9%), respectively. In total, 60% of the population reported four or more gastrointestinal symptoms. There was considerable overlap of IBS with dyspepsia and among the dyspepsia subgroups by application of the Rome criteria. Independently, 10 symptom groupings were identified by factor analysis. The underlying constructs measured by these factors were generally the major abdominal syndromes recognised by the Rome classification: dyspepsia, IBS, reflux, painless constipation, painless diarrhoea, and bloating, in addition to a number of more specific symptom groupings.

Conclusion—Gastrointestinal symptoms are common and overlap in the community, but distinct upper and lower abdominal symptom groupings can be identified.

  • functional bowel disease
  • irritable bowel syndrome
  • Rome criteria
  • dyspepsia
  • factor analysis

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