title: Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population.
abstract: BACKGROUND
  The current classification dividing patients with functional gastrointestinal symptoms into subgroups remains controversial.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Gastrointestinal symptoms are common and overlap in the community, but distinct upper and lower abdominal symptom groupings can be identified.
authors.affiliation: Department of Medicine, University of Sydney, Australia.
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
authors.forename: P
authors.initials: P
authors.lastname: Boyce
authors.forename: M
authors.initials: M
authors.lastname: Jones
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003109:Colonic Diseases, Functional / Q000453:epidemiology*; D004415:Dyspepsia / Q000453:epidemiology*; D005163:Factor Analysis, Statistical; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data