title: The Intestinal Gas Questionnaire: development of a new instrument for measuring gas-related symptoms and their impact on daily life.
abstract: BACKGROUND
  Although gas-related symptoms (GRS) are common and intrusive, there are no questionnaires to quantitate this problem. This study aimed to develop an instrument to rectify this gap in our knowledge.
  
  
  METHODS
  Concepts were initially identified from the literature and interviews with gastroenterologists. Exploratory one-to-one interviews and focus groups with irritable bowel syndrome (IBS) patients (n = 28) and non-IBS subjects (n = 27) with GRS were conducted in UK, France, and Spain leading to a conceptual framework for the questionnaire. Last, iterative rounds of cognitive debriefing were performed with IBS (n = 16) and non-IBS subjects (n = 14).
  
  
  RESULTS
  From the first three steps, nine GRS (bloating, distension, flatulence, odorous flatulence, difficult gas evacuation, stomach rumbling, belching, bad breath, and abdominal movement) were identified although abdominal movement was subsequently excluded. Twelve quality of life domains affected by these symptoms were identified as: Clothing, emotional, physical appearance, diet, daily living, work, social life, physical activity, relationships, sex life, sleep, and cognitive function. A 24-h recall for symptoms and a 7-day recall for impact assessment were supported by the qualitative findings. Cognitive debriefing confirmed the understanding of the instrument. Across the three languages, the instrument was conceptually and linguistically consistent.
  
  
  CONCLUSIONS
  The International Gas Questionnaire is a 2-part instrument, developed rigorously and simultaneously in three languages assessing seven symptoms (17 items) and their impact on 12 domains (26 items) in IBS and general population. It is now undergoing psychometric validation and should provide a unique tool for epidemiological surveys and clinical trials for developing new treatments for these symptoms.
authors.affiliation: Patient-Centered Outcomes Research, EA 7334, University Paris-Diderot, Paris, France.|Health Economics Clinical Research Unit, Hotel-Dieu hospital, AP-HP, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Chassany
authors.affiliation: HEOR & Strategic Market Access, Mapi, Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Tugaut
authors.affiliation: HEOR & Strategic Market Access, Mapi, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Marrel
authors.affiliation: Danone Nutricia Research, Palaiseau, France.
authors.forename: D
authors.initials: D
authors.lastname: Guyonnet
authors.affiliation: Endpoint Development and Outcomes Assessment, Adelphi Values, Manchester, UK.
authors.forename: R
authors.initials: R
authors.lastname: Arbuckle
authors.affiliation: Patient-Centered Outcomes Research, EA 7334, University Paris-Diderot, Paris, France.|Internal Medicine & Clinical Immunology Department, Bicêtre Hospital, AP-HP, Kremlin-Bicêtre, France.
authors.forename: M
authors.initials: M
authors.lastname: Duracinsky
authors.affiliation: Wythenshawe Hospital, Manchester, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Whorwell
authors.affiliation: Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Spain.|Department of Medicine, Universitat Autónoma de Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Azpiroz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004884:Eructation; D005260:Female; D005414:Flatulence; D017144:Focus Groups; D006209:Halitosis; D006304:Health Status; D006801:Humans; D043183:Irritable Bowel Syndrome; D008297:Male; D008875:Middle Aged; D009812:Odorants; D036301:Qualitative Research; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: IBS; gas-related symptoms; health-related quality of life; patient-centered outcomes; patient-reported outcomes; qualitative research; symptom