The Burden of Irritable Bowel Syndrome and Functional Dyspepsia in Poland: A Cross- Sectional Study from West Pomeranian Voivodship

doi:10.21203/rs.3.rs-5032998/v1

Download PDF

Research Article

The Burden of Irritable Bowel Syndrome and Functional Dyspepsia in Poland: A Cross- Sectional Study from West Pomeranian Voivodship

https://doi.org/10.21203/rs.3.rs-5032998/v1

This work is licensed under a CC BY 4.0 License

You are reading this latest preprint version

Background

Functional gastrointestinal disorders (FGIDs), now known as disorders of gut-brain interaction (DGBIs), such as Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD), significantly impact global health, reducing quality of life and burdening healthcare systems. This study addresses the epidemiological gap in Poland, focusing on the West Pomeranian Voivodeship.

Methods

We conducted a cross-sectional study of 2070 Caucasian patients (58.2% female, mean age 57.5 ± 15.1 years) undergoing gastrointestinal endoscopic examinations at Pomeranian Medical University from 2021 to 2023. Data were collected using Rome IV diagnostic questionnaires and correlated with gastroduodenoscopy and colonoscopy findings. Exclusion criteria were age under 18, pregnancy, Crohn’s disease, ulcerative colitis, severe comorbidities, cancer, immunosuppressive therapy, ileostomy/colostomy, incomplete questionnaires, or lack of consent.

Results

Using Rome IV criteria, IBS was diagnosed in 436 participants (21.1%) and FD in 248 participants (12.0%). Post-endoscopic evaluation revised FD diagnoses to 184 individuals (8.9%). Females had a higher prevalence of IBS and FD (OR 1.64 and 1.61, respectively). No significant association was found between higher BMI and increased risk of IBS and FD. Hypertension and diabetes prevalence were 35.1% and 13.0%, respectively. Individuals with a history of COVID-19 had a higher risk of developing IBS (OR 1.47, P = 0.050).

Conclusions

Our study provides crucial epidemiological data on IBS and FD in Poland, emphasizing the importance of endoscopic evaluations. Our findings highlight the need for regional studies to understand local DGBI prevalence, aiding targeted healthcare strategies.

irritable bowel syndrome

functional dyspepsia

gut-brain axis

endoscopy

Rome Criteria

Functional gastrointestinal disorders (FGIDs), now defined as the disorders of the gut-brain interaction (DGBIs)], including irritable bowel syndrome (IBS) and functional dyspepsia (FD), are one of the most commonly manifested and diagnosed gastrointestinal disorders worldwide[1], with varying prevalence between countries [2, 3]. DGBIs represent a significant health problem, leading to a reduced quality of life (QoL) and generating significant costs for the healthcare system [4, 5]. The incidence of DGBIs in the general population is high, with estimates of IBS prevalence to be around 11% globally, with significant regional variations, indicating the etiological complexity and the influence of environmental and cultural factors [1, 5, 6]. FD, affects approximately 21% of the global population, often overlapping with IBS and other DGBIs, further complicating diagnosis and treatment [6, 7]. In Poland the epidemiological data on the prevalence of DGBIs is limited, especially with regard to specific populations and regions.. A recent survey in Poland found that DGBIs affect women more frequently, with overlapping conditions leading to greater IBS severity, poorer quality of life, and increased healthcare utilization [8]. Lovell and Ford [9] analysed variations in IBS prevalence across different countries and regions, revealing significant regional disparities. Their work underscores the necessity of local epidemiological studies to comprehend the global burden of DGBIs.

Of relevance, most of the published data comes from the pre Covid-19 pandemic era. The impact of the recent Covid-19 pandemic on gastrointestinal health resulting in possible increase in DGBIs has already been reported [10–12]. Moreover the data available in Poland has derived mostly from patients’ self-reported surveys and questionnaires with data, not always supported by endoscopic examinations. The recent report of Sperber et al [13] highlighted the importance of the survey method (in-person household interviews vs Internet surveys) on symptom reporting and DGBI prevalence outcomes. Their findings hold significant implications for the future of DGBI research and epidemiological studies more broadly.

Our study seeks to fill the gap by providing epidemiological information on the prevalence of IBS and FD among community patients referred to the busy tertiary University Endoscopy Unit in the West Pomeranian Voivodeship in Poland. In light of the growing interest in DGBIs and their impact on public health, by closely examining these disorders in a local context, we hope to contribute to improving the care of patients suffering from these frequent and bothersome disorders. Studies on the epidemiology of DGBIs at a local level, such as ours, are essential to understand the true burden of DGBIs and should contribute to better tailoring of healthcare infrastructure to the needs of the local population.

Study design and patients

This cross-sectional study was conducted on a population of community patients undergoing GI endoscopic examinations - gastroduodenoscopy and colonoscopy in the Department of Gastroenterology at the Pomeranian Medical University in Szczecin in 2021–2023. The study group consisted of 2070 Caucasian individuals from the West Pomeranian region, including 866 men (41.8%) and 1204 women (58.2%). The age range was 18 to 96 years, with a mean of 57.5 ± 15.1 years and a median of 60 years (IQR Q1: 47- Q3: 69.). Data were collected using Rome IV questionnaires limited to FD and IBS modules, which were completed prior to the study and statistically correlated with endoscopic findings. During the GI endoscopic examination, selected patients had a GI mucosal biopsy when indicated. Helicobacter pylori status was evaluated in selected patients. To avoid selection bias we used random sampling. However, to ensure the integrity and reliability of the data, specific exclusion criteria were established that could have potentially biased the results of the study. These included: i) age under 18, ii) pregnant women, iii) subjects with severe comorbidities, iv) patients with inflammatory bowel disease (IBD), iv) subjects on immunosuppressive therapy, v) patients with ileal or colostomy, v) hospitalized patients, vi) patients referred to hospital for advanced endoscopic procedures (e.g. polypectomy, endoscopic mucosal or submucosal resection /EMR, ESD/ vi) incomplete questionnaires or lack of consent to participate in the study. When calculating sample size, we assumed that to estimate the prevalence of IBS in a voivodeship with a population of 1.7 million[14], aiming for a 95% confidence level, a margin of error of ± 5%, and accounting for a 20% non-response rate, we need a sample size of approximately 1728 people. This step was done manually using sample size formula for proportions, corrected for finite population and adjusted for non-response rate

Questionnaires

After an initial evaluation, study participants completed detailed epidemiological questionnaires, including questions on demographics, medical history, lifestyle and specific symptoms associated with IBS and FD, based on Rome IV Criteria. The latter one is a standardized and validated measurement tool minimizing any bias in data collection and measurement [15]. Moreover, collectors were trained how to use the survey correctly.

The Bristol Stool Form (BSF) scale was used to assess IBS subtypes. Subsequently, all participants underwent a series of GI endoscopic examinations, gastroduodenoscopy or colonoscopy to exclude other causes of symptoms. Rome IV Questionnaires License was purchased from Rome Foundation. The results of the study, combined with the information from the questionnaires, formed the basis for the diagnosis of IBS and FD according to Rome Criteria IV.

Data analysis

The study was approved by the ethics committee of the Pomeranian Medical University in Szczecin (resolution no KB-0012/197/19) and all participants gave written informed consent to participate. Data protection was ensured in accordance with current legislation. The methodology provides a comprehensive approach to investigate the epidemiology of DGBIs in a narrow local population of the West-Pomeranian Voivodeship in Poland, taking into account both demographic and clinical aspects. Patient data with complete information were analysed.

Statistical analysis

Categorical Data Analysis

For categorical data analysis, we used the Chi-square test or Fisher's exact test, as appropriate, to assess the associations between categorical variables. To quantify the strength of these associations, we calculated the odds ratios (OR) with 95% confidence intervals (CI) using the epitools package in R (https://cran.r-project.org/).

Generalized Linear Model (GLM)

To investigate the relationship between Body Mass Index (BMI) and the likelihood of developing Irritable Bowel Syndrome (IBS), Functional Dyspepsia (FD), or the overlap of IBS and FD, we employed a generalized linear model (GLM) with a binomial family. The GLM included BMI and gender as predictors, and an interaction term between BMI and gender was also included to explore potential gender differences in the relationship between BMI and the likelihood of these gastrointestinal conditions. We interpreted the results of the GLM graphically using predictor effect plots generated with the effects package in R. The vertical axis of these plots was specified using the "response" type, thereby expressing the y-axis in probability units, which provides an intuitive interpretation of the likelihood of IBS, FD, or their overlap in relation to BMI and gender. All statistical analyses were performed using R, and a significance level of 0.05 was used for all tests.

Among total number of 26 163 individuals attending Pomeranian Medical University Endoscopic Centre in 2021–2023, there were 15 698 potentially eligible patients, 6279 examined for eligibility, 3767 confirmed eligible, 2150 included in the study, and 2070 completing follow-up and analysed. The primary reason for not including patients after being confirmed eligible was not enough personnel to collect data for the present study in the Clinic.

The mean age of participants was 57.5 ± 15.1 years, with 58.2% (N = 1204) being females. The mean body mass index (BMI) was 27.1 ± 6.3 kg/m². Among the participants, 427 (20.6%) reported previous COVID-19 infection. The common comorbidities such as hypertension and diabetes mellitus were present in 35.1% (N = 726) and 13.0% (N = 270), respectively.

Using the Rome IV Criteria, 436 (21%) subjects met the criteria for a diagnosis of IBS, while functional dyspepsia (FD) was identified in 248 (12%) participants. Considering the overlap between the two conditions, 310 (15.0%) subjects had IBS, 122 (5.9%) had FD, and 126 (6.1%) met the criteria for both IBS and FD based on the questionnaires (Fig. 1A). Since the criteria for FD require the absence of organic, metabolic, and systemic changes that could likely cause symptoms, we re-evaluated the diagnoses using GI endoscopic findings, which were identified as gastric or duodenal mucosal abnormalities, including gastric and/or duodenal erosions and ulcers, along with the presence of Helicobacter pylori infection in some subjects. After this re-evaluation, 90 (4.35%) subjects met the criteria for FD, resulting in 94 (4.54%) subjects with overlapping IBS and FD (Fig. 1B).

Figure 1.

Figure 2 illustrates the prevalence of IBS, FD, and overlapping IBS/FD diagnoses among males and females. The bar plots demonstrate that both conditions and their overlap exhibit distinct patterns based on sex. Notably, the data reveals that females are more likely to be diagnosed with IBS and FD compared to males in both questionnaire-based (Fig. 2A, Chi-square = 29.03, P < 0.0001) and gastroscopic-based revised diagnoses (Fig. 2B, Chi-square = 21.06, P < 0.001). This sex-specific prevalence suggests potential underlying biological, hormonal, or psychosocial factors that may contribute to these differences.

Figure 2.

The odds ratio (OR) for being diagnosed with IBS was calculated to assess the likelihood of females being diagnosed with IBS compared to males. For the non-revised diagnoses, the analysis revealed an OR of 1.636 (95% CI: 1.266–2.12, P < 0.001). This indicates that females have a significantly higher likelihood of being diagnosed with IBS compared to males, with an estimated 63.6% increased odds. Similarly, for the revised diagnoses, the OR was 1.60 (95% CI: 1.24–2.06, P < 0.001). For FD, the OR for the non-revised diagnoses was 1.46 (95% CI: 0.99–2.15, P = 0.058), indicating a non-significant trend towards higher odds in females. However, the revised diagnoses showed a statistically significant OR of 1.61 (95% CI: 1.03–2.52, P = 0.038), suggesting that females have a 61% higher likelihood of being diagnosed with FD compared to males after revision. Regarding the overlap group (IBS + FD), the non-revised diagnoses showed an OR of 2.24 (95% CI: 1.49–3.36, P < 0.0001), indicating that females have more than twice the odds of being diagnosed with both conditions compared to males. The revised diagnoses presented an OR of 1.80 (95% CI: 1.15–2.83, P = 0.009), confirming that females still have significantly higher odds of overlapping diagnoses of IBS and FD. The process of revising the FD diagnoses appears to have a notable impact on the strength and significance of the observed associations. While the non-revised data already indicates significant sex differences, the revised data often shows a slight reduction in the odds ratios but enhances statistical significance, particularly for FD.

Figure 3.

Proportion of patients referred for GI endoscopic examination based on indication differed significantly in both without (P < 0.0001, Fig. 3A) and with gastroscopic evaluation (P < 0.0001, Fig. 3B).

In patients with IBS changes in bowel movements were as follows: diarrhoea (N = 109), constipation (N = 117) or both (N = 73) and reported by 68.6% (N = 299) of respondents, Fig. 4A). Among individuals with FD, the predominant symptoms included upper abdominal pain (63.3% of respondents, N = 157) and a feeling of fullness or early satiety after meals (36.7%, N = 91), Fig. 4B.

Figure 4.

Analysis of stool types among IBS patients showed that 25% suffered from diarrhea, 26.8% from constipation and 31.4% had stools of normal consistency. Among those with dyspepsia, abdominal pain was the main symptom, reported by 63.3% of patients.

Impact of COVID-19

Our statistical analysis revealed that individuals with a history of COVID-19 infection had a higher risk of developing IBS compared to those without such a history, although this result was only borderline significant (OR = 1.47, 95% CI 1.01–2.15, P = 0.050). In contrast, the odds ratio (OR) for developing FD among those with a history of COVID-19 infection was 1.22 (95% CI 0.59–2.52, P = 0.562), indicating no significant association.

Gastrointestinal endoscopic findings among patients with IBS and FD

The analysis of colonoscopy findings (Fig. 5) revealed significant differences in the odds of detecting polyps and inflammation among the different groups (P = 0.0007 and P = 0.012, respectively). When evaluating the presence of polyps (Fig. 5A), the odds ratio (OR) for the FD group compared to the reference group (Other) was 0.21 (95%CI 0.08–0.55, P = 0.0002), indicating a significantly lower likelihood of finding polyps in the FD group. In contrast, the IBS group showed an OR of 0.67 (95%CI 0.47–0.96, P = 0.030), suggesting a moderately reduced odds of polyp detection compared to the reference group. The combined IBS and FD group had an OR of 0.69 (95%CI 0.38–1.27, P = 0.305), which was not statistically significant, indicating no substantial difference from the reference group in terms of polyp detection.

Figure 5.

For inflammation findings during colonoscopy (Fig. 5C), the FD group had an OR of 0.36 (95%CI 0.05–2.68, P = 0.509), showing no significant difference from the reference group. However, the IBS group exhibited significantly higher odds of detecting inflammation, with an OR of 2.12 (95%CI 1.23–3.65, P = 0.012). The combined IBS and FD group also demonstrated increased odds of inflammation with an OR of 2.08 (95% CI 0.85, 5.09, P = 0.128), although this result was not statistically significant.

Figure 6.

The gastroduodenoscopy examination results demonstrated varying odds of detecting specific conditions across different patient groups (Fig. 6). For GERD (Fig. 6A), the odds ratio (OR) compared to the reference group (Other) was 0.95 (95%CI 0.48–1.87, P = 1.0), indicating no significant difference in the likelihood of finding GERD between the groups. In contrast, the odds of identifying gastro-duodenal pathology were significantly lower in the group under examination, with an OR of 0.25 (95%CI 0.11–0.55, P < 0.0001), suggesting a markedly reduced likelihood of this condition compared to the reference group. For Ulcer Disease, the OR was 1.61 (95% CI 0.45–5.68, P = 0.442), showing no statistically significant difference from the reference group, implying that the odds of detecting ulcers were similar across the groups. Lastly, the detection of Hiatal Hernia had an OR of 1.34 (95% CI 0.50–3.57, P = 0.579), also indicating no significant difference in the likelihood of finding hernias between the examined group and the reference group.

The association between the BMI and the probability of diagnoses was analysed using a generalized linear model with BMI and sex as independent variables and their interaction. We found no significant association for BMI. Predictor effect plots illustrating the relationship between BMI and the probability of diagnoses, as well as the interaction effect between BMI and sex, are shown in Fig. 7.

Figure 7.

In our study, we reported that after a 12 months follow-up period, out of 554 follow-up responses of subjects initially fulfilling the IV criteria of IBS or FD diagnoses − 248 (49.6%) responders fulfilled the criteria for FD and 435 (45.5%) for IBS.

In the current study, we aimed to assess the prevalence and characteristics of common DGBIs, including IBS and FD among 2070 Caucasian individuals of West Pomeranian Voivodeship undergoing gastrointestinal endoscopic examinations at the Pomeranian Medical University in Szczecin, Poland from 2021 to 2023. Our investigation utilized the Rome IV criteria, combined with endoscopic evaluations, to diagnose these disorders.

This regional analysis was compared against the data of other studies to provide a comprehensive understanding of these conditions in Poland. In our study, using the Rome IV criteria, 436 participants (21.1%) were diagnosed with IBS and 248 participants (12.0%) with FD. Following endoscopic evaluation, the number of FD diagnoses was revised to 184 individuals (8.9%). Females showed a higher prevalence of both IBS and FD, with odds ratios of 1.64 and 1.61, respectively. There was no significant association between a higher BMI and an increased risk of IBS or FD. Participants with a history of COVID-19 had a higher risk of developing IBS, with an odds ratio of 1.47.

The prevalence of IBS and FD vary among countries and cultures, which may result from a variety of environmental and psychological factors, among them i) stress [16] ii) diet [17] iii) microbiota composition and function [18] as well as iv) genetic and comorbid conditions [19].

Among studies conducted in Poland, a survey performed by Ziolkowski et al. with 850 Polish adults revealed that around 13% of them experienced IBS [20]. Conversely, a different study of attendees at the Woodstock Rock Festival in Poland found that approximately 19% of participants exhibited symptoms of IBS [21]. Mulak’s recent exploration of the sex and gender differences of DGBIs in Poland on a sample of 2057 Polish adults collected via an Internet survey, which included the Rome IV diagnostic questionnaire [8] reported the overall prevalence 4.4% of IBS and 8.3% of FD of the population in Poland. [8]. By analysing our data through Mulak’s findings, we can further delineate how these variables affect IBS and FD in the West Pomeranian population, potentially guiding targeted healthcare strategies[8]. Our study, along with others [22] [23], confirms that women are more frequently affected by IBS and FD, with estimates suggesting that women account for more than 70% of all IBS cases..

Dumitrascu’s et al [24] identified significant gaps in epidemiological data on IBS in Central and East European countries. Many rely on small, local studies or unpublished data, highlighting the need for more comprehensive and standardized research. The variation in study designs, diagnostic criteria, and reporting standards across the region also affects perceived prevalence rates and underscores the need for improved research methodologies.[24].

Our study revealed a 21.1% prevalence of IBS and 8.9% prevalence of FD in the West Pomeranian Voivodeship of Poland. While IBS prevalence varies regionally, data are limited and inconclusive. A recent Rome Foundation survey reported a 12% prevalence of FD across the USA, Canada, and the UK, relying on self-reported data without endoscopic verification [25]. Our study found that many initially diagnosed FD cases had underlying organic causes, revising FD prevalence to 8.9% after endoscopic evaluation. Both studies identified gender differences, with women more frequently affected; our findings showed higher odds for women being diagnosed with IBS (OR 1.64) and FD (OR 1.61), consistent with the Rome Foundation study [25]. Of relevance, the recent systematic review of Lee et al. [26] found the global prevalence of functional dyspepsia (FD) to be 8.4% (95% CI 7.4–9.5), with variations based on diagnostic criteria, region, and demographics. The lowest prevalence of FD was reported with Rome IV (6.8%). Developing countries had a higher prevalence (9.1%) than developed countries (8.0%), and women were more affected than men (9.0% vs. 7.0%). The prevalence decreased from 12.4% in 1990–2002 to 7.3% in 2013–2020, indicating a gradual global decline over time [26]. A nationwide multicentre study in Korea (Sept 2016 - June 2017) involving 1714 subjects found a 10.3% prevalence of functional dyspepsia (FD), with subtypes being postprandial distress syndrome (4.8%), epigastric pain syndrome (3.0%), and both (2.5%). Among those aged 60+, females had a higher FD risk (OR 2.90). These results emphasize the need for focused attention on these risk factors, especially in older adults [27].

In the current study we have shown a statistically no significant association between higher BMI and an increased risk of developing IBS and FD. Observations reported by Lacy and Patel [28], suggested that weight control may play a role in the prevention and treatment of DGBI disorders. The prevalence of obesity among IBS patients varied significantly across published studies, ranging from 11.6–42%. This variability is likely due to differences in study populations, methodologies, and diagnostic criteria used [19, 29]. The systematic review by Zia et al. evaluated the risk factors for abdominal pain-related disorders of gut-brain interaction, including IBS, and highlighted obesity as a significant risk factor [30]. However the results of our current study do not support these observations.

A cross-sectional survey conducted in Japan by Otani et al. [34], using Rome IV criteria, examined upper GI endoscopic findings in subjects with functional constipation (FC) and IBS. The study found that IBS patients often had overlapping symptoms and conditions like erosive gastritis and duodenitis, with notable gender differences in prevalence and higher reports of psychological symptoms and stress. Our study supports these findings, showing a high prevalence of IBS and FD, especially among women, with significant endoscopic findings like mucosal abnormalities. Otani's large cohort study provided comprehensive data on upper GI findings in IBS patients [34]. The overall data, however, is contrasting. Staller et al. [31] reported low diagnostic yield of upper GI endoscopy and colonoscopy for organic disease among patients with IBS diagnosis.. Mao et al. [32] in their cross-sectional study reported clinically significant findings, detectable by endoscopy in 29.9% of dyspeptic patients with no warning symptoms. The endoscopy findings included oesophageal lesions, peptic ulcers, and malignancy. Multivariate logistic regression analysis revealed that males, body mass index, epigastric pain and Helicobacter pylori infection were independent risk factors for the presence of clinically significant findings on endoscopy [32]. Al-Abachi et al. [33] in a single-centre cross-sectional descriptive study of 372 patients presenting with dyspepsia and undergoing GI endoscopic examination, reported minor or normal endoscopic findings in the majority of dyspeptic patients. Age above 50 years, alarm symptoms, and use of non-steroidal inflammatory drugs (NSAIDs) were predictive of clinically relevant endoscopic lesions. Lorraine-Francis et al. [34] based on their study investigating patients, presenting with symptoms compatible with Rome IV criteria for functional dyspepsia reported no diagnostic yield of endoscopic examination. Therefore authors recommended the positive diagnosis of FD, without endoscopy in patients without alarm symptoms. Similarly, Miwa et al. [35], based on their revised Japanese FD guidelines, specified the necessity of endoscopic examination only in patients with suspected organic disease. These reports are in line with British, European and North American guidelines, which recommend that patients with dyspepsia and no alarm featured, should be managed without upper GI endoscopy [36–38]. In our study, we examined FD prevalence among patients in a busy university ambulatory endoscopy unit. Endoscopic evaluations reduced the FD diagnosis rate from 12.0–8.9%, emphasizing the importance of these evaluations in accurately diagnosing FD and distinguishing it from organic diseases. This highlights the need for thorough endoscopic assessments, optimization of treatment strategies, and patient reassurance to address underlying organic causes and improve overall care.

In our study, we followed our patients after 12 months after initial diagnosis. We reported that out of 554 follow-up responses of subjects initially fulfilling the IV criteria either of IBS, FD or IBS + FD diagnoses 248 (49.6%) responders fulfilled the criteria for FD and 435 (45.5%) for IBS. The results of our study are in line with recent systematic review and meta-analysis of 47 observational studies of adults > 50 years old, reporting FD and IBS following the history of acute gastroenteritis. The overall prevalence of post infectious IBS (PI-IBS) and FD (PI-FD) were 14.5% and 12.7% respectively, with 39.8% of PI-IBS patients still reporting symptoms, in the long term > 5 years follow up [39]. An interesting contrast lies in the association with COVID-19. Our study found a borderline significant higher risk of developing IBS among individuals with a history of COVID-19 infection (OR 1.47), which supports our previous observations [11, 12].

Our cross-sectional study has several limitations that must be considered when interpreting the findings. The data was captured at a single point in time, thus the ability to establish causal relationships is limited. Also, a recall and cognitive biases could have influenced the accuracy of survey-collected data. Additionally, the findings are based on prevalence data without insights into incidence or longitudinal trends.

In conclusion, our study provides valuable epidemiological data on IBS and FD in West Pomeranian Voivodeship, aligning with global trends of widespread prevalence [1, 13].

Our findings contribute to understanding these disorders locally. Future research should combine local and broad population-based approaches to develop a comprehensive understanding of DGBIs globally.

· APC: Argon Plasma Coagulation

· BMI: Body Mass Index

· BSF: Bristol Stool Form

· CI: Confidence Interval

· COVID-19: Coronavirus Disease 2019

· DGBI: Disorders of Gut-Brain Interaction

· EGD: Esophagogastroduodenoscopy

· EMR: Endoscopic Mucosal Resection

· ERCP: Endoscopic Retrograde Cholangiopancreatography

· ESD: Endoscopic Submucosal Dissection

· EUS: Endoscopic Ultrasound

· FD: Functional Dyspepsia

· FGID: Functional Gastrointestinal Disorders

· GI: Gastrointestinal

· GLM: Generalized Linear Model

· IBS: Irritable Bowel Syndrome

· IBD: Inflammatory Bowel Disease

· OR: Odds Ratio

· PEG: Percutaneous Endoscopic Gastrostomy

· POEM: Per Oral Endoscopic Myotomy

· QoL: Quality of Life

· RCT: Randomized Controlled Trial

· SPSS: Statistical Package for the Social Sciences

· US: United States

· UK: United Kingdom

Ethics approval and consent to participate: The study was approved by the ethics committee of the Pomeranian Medical University in Szczecin (resolution no KB-0012/197/19) and all participants gave written consent to participate.

Consent for publication: not applicable

Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request

Competing interests: The authors declare that they have no competing interests with respect to this work

Funding: the study was financed by Program of the Ministry of Science and Health Education under the name of “Regional Initiative of Excellence” in 2019-2022 project number 002/RID/2018/19 amount of financing 12.000.000 PLN

Authors' contributions:

PK and WM conception and design of the work;

All authors data acquisition

PK, WM, MK, KSZ analysis and interpretation of data;

PK have drafted the work
All authors substantively revised and approved it

Acknowledgments: none

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;160:99-114.e3.
Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5:908–17.
Almario CV, Sharabi E, Chey WD, Lauzon M, Higgins CS, Spiegel BMR. Prevalence and Burden of Illness of Rome IV Irritable Bowel Syndrome in the United States: Results From a Nationwide Cross-Sectional Study. Gastroenterology. 2023;165:1475–87.
Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV. 2016;150:20.
Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71–80.
Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut. 2015;64:1049–57.
Fairlie T, Shah A, Talley NJ, Chey WD, Koloski N, Yeh Lee Y, et al. Overlap of disorders of gut-brain interaction: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8:646–59.
Mulak A, Freud T, Waluga M, Bangdiwala SI, Palsson OS, Sperber AD. Sex- and gender-related differences in the prevalence and burden of disorders of gut-brain interaction in Poland. Neurogastroenterol Motil. 2023;35:e14568.
Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:712-721.e4.
Elmunzer BJ, Palsson OS, Forbes N, Zakaria A, Davis C, Canakis A, et al. Prolonged Gastrointestinal Manifestations After Recovery From COVID-19. Clin Gastroenterol Hepatol. 2024;22:1098-1107.e3.
Nazarewska A, Lewandowski K, Kaniewska M, Rosołowski M, Marlicz W, Rydzewska G. Irritable bowel syndrome following COVID-19: an underestimated consequence of SARS-CoV-2 infection. Pol Arch Intern Med. 2022;132:16323.
Nazarewska A, Lewandowski K, Kaniewska M, Tulewicz-Marti E, Więcek M, Szwarc P, et al. Long-lasting dyspeptic symptoms - another consequence of the COVID-19 pandemic? Prz Gastroenterol. 2023;18:175–82.
Sperber AD, Bor S, Fang X, Bangdiwala SI, Drossman DA, Ghoshal UC, et al. Face-to-face interviews versus Internet surveys: Comparison of two data collection methods in the Rome foundation global epidemiology study: Implications for population-based research. Neurogastroenterol Motil. 2023;35:e14583.
GUS - Bank Danych Lokalnych. https://bdl.stat.gov.pl/BDL/start. Accessed 24 Jul 2024.
Palsson OS, Whitehead WE, van Tilburg MAL, Chang L, Chey W, Crowell MD, et al. Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians. Gastroenterology. 2016;:S0016-5085(16)00180-3.
Fairlie T, Shah A, Wong RK, Fang X, Ghoshal UC, Kashyap PC, et al. A multifaceted ecological approach to explore links between environmental factors and the epidemiology of disorders of gut–brain interaction. Neurogastroenterology & Motility. n/a n/a:e14866.
Dimidi E, McArthur AJ, White R, Whelan K, Lomer MCE. Optimizing educational methods for the low FODMAP diet in disorders of gut-brain interaction: A feasibility randomized controlled trial. Neurogastroenterol Motil. 2023;35:e14640.
Marasco G, Cremon C, Barbaro MR, Bianco F, Stanghellini V, Barbara G. Microbiota modulation in disorders of gut-brain interaction. Dig Liver Dis. 2024;:S1590-8658(24)00742-4.
Chen Y, Yang H, Song J, Chen W, Liu K, Liu B, et al. Associations of modifiable factors with risk of irritable bowel syndrome. Front Nutr. 2024;11:1362615.
Ziółkowski BA, Pacholec A, Kudlicka M, Ehrmann A, Muszyński J. Prevalence of abdominal symptoms in the Polish population. Gastroenterology Rev. 2012;7:20–5.
Palma J, Antoniewicz J, Borecki K, Tejchman K, Skonieczna-Żydecka K, Maciejewska-Markiewicz D, et al. Irritable Bowel Syndrome Prevalence among Participants of Woodstock Rock Festival in Poland Based on Rome IV Criteria Questionnaire. Int J Environ Res Public Health. 2021;18:11464.
Bosman MHMA, Weerts ZZRM, Snijkers JTW, Vork L, Mujagic Z, Masclee AAM, et al. The Socioeconomic Impact of Irritable Bowel Syndrome: An Analysis of Direct and Indirect Health Care Costs. Clin Gastroenterol Hepatol. 2023;21:2660–9.
Niemyjska S, Ukleja A, Ławiński M. Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students. Pol Przegl Chir. 2015;87:252–9.
Dumitrascu DL, Babin A, Bordin DS, Czimmer J, Dorofeyev A, Galica A, et al. Recent Data on Irritable Bowel Syndrome from some Central and East European Countries. J Gastrointestin Liver Dis. 2020;29:247–50.
Aziz I, Palsson OS, Törnblom H, Sperber AD, Whitehead WE, Simrén M. Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study. Lancet Gastroenterol Hepatol. 2018;3:252–62.
Lee K, Kwon C-I, Yeniova AÖ, Koyanagi A, Jacob L, Smith L, et al. Global prevalence of functional dyspepsia according to Rome criteria, 1990-2020: a systematic review and meta-analysis. Sci Rep. 2024;14:4172.
Kim SE, Kim N, Lee JY, Park KS, Shin JE, Nam K, et al. Prevalence and Risk Factors of Functional Dyspepsia in Health Check-up Population: A Nationwide Multicenter Prospective Study. J Neurogastroenterol Motil. 2018;24:603–13.
Lacy BE, Patel NK. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017;6:99.
Yamamoto Y, Furukawa S, Watanabe J, Kato A, Kusumoto K, Takeshita E, et al. Association Between Body Mass Index and Functional Dyspepsia in Young Japanese People. J Neurogastroenterol Motil. 2022;28:276–82.
Zia JK, Lenhart A, Yang P-L, Heitkemper MM, Baker J, Keefer L, et al. Risk Factors for Abdominal Pain-Related Disorders of Gut-Brain Interaction in Adults and Children: A Systematic Review. Gastroenterology. 2022;163:995-1023.e3.
Staller K, Olén O, Söderling J, Roelstraete B, Törnblom H, Khalili H, et al. Diagnostic yield of endoscopy in irritable bowel syndrome: a nationwide prevalence study 1987–2016. Eur J Intern Med. 2021;:S0953-6205(21)00267-3.
Mao L-Q, Wang S-S, Zhou Y-L, Chen L, Yu L-M, Li M, et al. Clinically significant endoscopic findings in patients of dyspepsia with no warning symptoms: A cross-sectional study. World J Clin Cases. 2021;9:3597–606.
Al-Abachi KT. Diagnostic value of endoscopy in adult patients with dyspepsia. Prz Gastroenterol. 2022;17:274–9.
Lorraine-Francis H, Newberry E, Aziz I. Diagnostic yield of upper gastrointestinal endoscopy in patients attending a UK centre with symptoms compatible with Rome IV functional dyspepsia. Frontline Gastroenterol. 2023;14:306–11.
Miwa H, Nagahara A, Asakawa A, Arai M, Oshima T, Kasugai K, et al. Evidence-based clinical practice guidelines for functional dyspepsia 2021. J Gastroenterol. 2022;57:47–61.
Black CJ, Paine PA, Agrawal A, Aziz I, Eugenicos MP, Houghton LA, et al. British Society of Gastroenterology guidelines on the management of functional dyspepsia. Gut. 2022;71:1697–723.
Wauters L, Dickman R, Drug V, Mulak A, Serra J, Enck P, et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia. United European Gastroenterol J. 2021;9:307–31.
Moayyedi P, Lacy BE, Andrews CN, Enns RA, Howden CW, Vakil N. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol. 2017;112:988–1013.
Porcari S, Ingrosso MR, Maida M, Eusebi LH, Black C, Gasbarrini A, et al. Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: systematic review and meta-analysis. Gut. 2024. https://doi.org/10.1136/gutjnl-2023-331835.

No competing interests reported.

GRAPHABSTRACT.png

Download PDF

Editorial decision: Revision requested
10 Sep, 2024
Editor assigned by journal
10 Sep, 2024
Submission checks completed at journal
05 Sep, 2024
First submitted to journal
04 Sep, 2024

You are reading this latest preprint version

The Burden of Irritable Bowel Syndrome and Functional Dyspepsia in Poland: A Cross- Sectional Study from West Pomeranian Voivodship

Status:

Version 1

Abstract

Background

Methods

Results

Conclusions

Figures

Background

Methods

Data analysis

Statistical analysis

Categorical Data Analysis

Generalized Linear Model (GLM)

Results

Discussion

Abbreviations

Declarations

References

Additional Declarations

Supplementary Files

Status:

Version 1