Original article
Prevalence and Socioeconomic Impact of Upper Gastrointestinal Disorders in the United States: Results of the US Upper Gastrointestinal Study

https://doi.org/10.1016/S1542-3565(05)00153-9Get rights and content

Background & Aims: This study examined the prevalence of upper gastrointestinal (GI) symptoms and symptom groupings and determined impact on disability days in a nationally representative US sample.

Methods: A telephone survey of 21,128 adults was conducted including questions about the presence of upper GI symptoms during the past 3 months. Respondents were categorized as symptomatic (ie, reported GI symptoms once per month) or asymptomatic. The survey included questions about missed work, leisure activity, or household activity days. Symptom groupings were identified by using factor analysis, and cluster analysis was used to assign respondents into distinct groups on the basis of these symptom groupings.

Results: The prevalence of an average of 1 or more upper GI symptoms during the past 3 months was 44.9%. The most common symptoms experienced during the past 3 months were early satiety, heartburn, and postprandial fullness. Factor analysis identified 4 symptom groupings: (1) heartburn/regurgitation; (2) nausea/vomiting; (3) bloating/abdominal pain; and (4) early satiety/loss of appetite. Five respondent clusters were identified; the largest clusters were primarily early satiety/fullness (44%) and gastroesophageal reflux disease-like symptoms (28%). Two small clusters reflected nausea and vomiting (7%) and a heterogeneous symptom profile (4%). Symptomatic respondents reported significantly more missed work, leisure, and household activity days than asymptomatic respondents (all P < .0001).

Conclusions: Factor analysis separated GI symptoms into groupings reflecting gastroesophageal reflux disease and dyspepsia: early satiety, postprandial fullness, and loss of appetite; bloating and abdominal pain/discomfort; and nausea and vomiting. These upper GI symptoms were associated with significant loss of work and activity days.

Section snippets

Design and Sample

A US national telephone survey was conducted to estimate variation in prevalence and impact of upper GI symptoms in the general population. A US nationwide random sample of telephone numbers was obtained to conduct a survey of English speaking adults 18 years and older. Before initiating the survey, telephone numbers were assigned an 8-digit random number, sorted by random number, and called in order as sorted.

A quota method27, 28 was used to yield a sample representative of the continental US

Respondents

All 24 gender-region-age strata were reached, and a total of 21,128 interviews were completed between April and September 1999. A total of 65,860 households were contacted, with 24,734 defined as ineligible. The 2 most common reasons for ineligibility were incompatible schedule (n = 14,812) and language barrier (n = 4516). From eligible households, 73.7% agreed to participate in the survey (ie, gave a complete or partial interview). Of those who participated, 12.6% gave a partial interview.

The

Discussion

The US Upper Gastrointestinal Study is the largest general population survey of upper GI symptoms conducted in North America. The study sample is unique because it includes a mix of respondents, representative of the US noninstitutionalized population who might or might not have accessed health care services for their GI symptoms. The most common upper GI symptoms reported in the general population were early satiety, defined as loss of appetite or feeling full soon after starting to eat,

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    Supported by Janssen Research Foundation, Titusville, NJ.

    Drs Coulie, Dubois, and Jones are employees of Johnson & Johnson. Dr Revicki and Ms Rentz are employees of MEDTAP International and have received research study support from Johnson & Johnson, Novartis, GlaxoSmithKline, and AstraZeneca. Dr Camilleri has served as a consultant to Johnson & Johnson within federal guidelines for nonsignificant financial conflict of interest based on annual income. He has also received research study support from Johnson & Johnson. Dr Kahrilas has received research study support from AstraZeneca, Medtronics, and Janssen Esai. Dr Whitehead has served as a consultant to Johnson & Johnson within federal guidelines for nonsignificant financial conflict of interest based on annual income. He has also received research study support from Johnson & Johnson, Solvay Pharmaceuticals, AstraZeneca, and Forest Labs.

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