Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders.
Functional gastrointestinal disorders, including the irritable bowel syndrome, account for up to 40% of referrals to gastroenterologists, but accurate data on the natural history of these disorders in the general population are lacking. Using a reliable and valid questionnaire, the authors estimated the onset and disappearance of symptoms consistent with functional gastrointestinal disorders. An age- and sex-stratified random sample of 1,021 eligible residents of Olmsted County, Minnesota, aged 30-64 years were initially mailed the questionnaire; 82% responded (n = 835). In a remailing to responders 12-20 months later, 83% responded again (n = 690). The age- and sex-adjusted prevalence rates per 100 for irritable bowel syndrome, chronic constipation, chronic diarrhea, and frequent dyspepsia were 18.1 (95% confidence interval (CI) 15.1-21.1), 14.7 (95% CI 11.9-17.4), 7.3 (95% CI 5.3-9.3), and 14.1 (95% CI 11.5-16.8), respectively, on the second mailing. Symptoms were not significantly associated with nonresponse to the second mailing; moreover, the estimated prevalence rates were not significantly different from the first mailing. Among the 582 subjects free of the irritable bowel syndrome on the first survey, 9% developed symptoms during 795 person-years of follow-up, while 38% of the 108 who initially had the irritable bowel syndrome did not meet the criteria after 146 person-years of follow-up. Similar onset and disappearance rates were observed for the other main symptom categories. While functional gastrointestinal symptoms are common in middle-aged persons and overall prevalence appears relatively stable over 12-20 months, substantial turnover is implied by the observed onset and disappearance rates; several potential sources of bias do not seem to account for this variation.
Talley
N J
NJ
Division of Gastroenterology and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905.
Weaver
A L
AL
Zinsmeister
A R
AR
Melton
L J
LJ
D000328:Adult; D000367:Age Factors; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005762:Gastroenterology; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012075:Remission, Spontaneous; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards