Changes in symptoms and lifestyle factors in patients seeking healthcare for gastrointestinal symptoms: an 18-year follow-up study.
BACKGROUND
Gastrointestinal symptoms and lifestyle change over time. The data from this 18-year longitudinal study are intended to further elucidate the long-term natural course of functional gastrointestinal (GI) symptoms and possible influencing factors.


OBJECTIVE
The aim of this study was to evaluate the correlation between lifestyle factors over time by reassessing symptom profiles in patients who presented with GI symptoms in 1990.


METHODS
The study population comprises a subset of individuals enrolled in the Swedish Dyspepsia Study, which commenced in 1990. In 1990, each participant in the Swedish Dyspepsia Study underwent physical assessment and completed a computer-based questionnaire on eight GI symptoms and lifestyle factors. An identical questionnaire was completed in 2008.


RESULTS
In total, 137 participants, 85 women and 52 men, were included in the follow-up study. None of the symptoms increased in frequency. Four of the symptoms decreased in frequency: abdominal pain [odds ratio (OR) 2.70], flatulence (OR 4.09), nausea (OR 3.05), and acid regurgitation (OR 1.59). Significant lifestyle changes included increased BMI (P<0.0001), decreased tobacco smoking (P<0.0001), and milk drinking (P=0.0080). Increased exercise was correlated with a decrease in acid regurgitation (OR 3.05) and vomiting (OR 7.38), but an increase in diarrhea (OR 0.23) and nausea (OR 0.33). Decreased smoking was correlated with a decrease in acid regurgitation (OR 3.45) and heartburn (OR 2.91).


CONCLUSIONS
The results indicated that the lifestyle changes in the studied population followed the same pattern as seen in the general population, and changes in lifestyle factors may have an impact on GI symptoms and may guide symptom management in the patient, all in order to reduce personal suffering and healthcare costs in the form of fewer visits to the doctor and lower numbers of drug prescriptions.
aDepartment of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gavle, Gavle bKarolinska University Hospital cDepartment of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm dVP Novartis Pharma AG, Basel, Switzerland.
Kerstin
K
Stake-Nilsson
Rolf
R
Hultcrantz
Peter
P
Unge
Yvonne
Y
Wengström
D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D015897:Comorbidity; D004415:Dyspepsia / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D005414:Flatulence / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult