title: Multicultural Aspects in Functional Gastrointestinal Disorders (FGIDs).
abstract: Cross-cultural factors are important in functional gastrointestinal disorders (FGIDs). In the setting of FGIDs, the aims of this review were to: 1) engender interest in global aspects; 2) gain a clearer understanding of culture, race and ethnicity and their effect on patient care and research; 3) facilitate cross-cultural clinical and research competency; and 4) improve and foster the quality and conduct of cross-cultural, multinational research. Cultural variables are inevitably present in the physician-patient context. Food and diets, which differ among cultural groups, are perceived globally as related to or blamed for symptoms. From an individual perspective, biological aspects, such as genetics, the microbiome, environmental hygiene, cytokines and the nervous system, which are affected by cultural differences, are all relevant. Of equal importance are issues related to gender, symptom reporting and interpretation, and family systems. From the physician's viewpoint, understanding the patient's explanatory model of illness, especially in a cultural context, affects patient care and patient education in a multicultural environment. Differences in the definition and use of Complementary and Alternative Medicine and other issues related to healthcare services for the FGIDs are also a relevant cross-cultural issue. This paper highlights the importance of cross-cultural competence in clinical medicine and research.
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1(#)Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Xiucai
authors.initials: X
authors.lastname: Fang
authors.affiliation: Full Professor, Department Internal Medicine, Universidade Federal do Rio Grande do Sul, Chief, Gastroenterology Division, Hospital de Clínicas de Porto Alegre Address: Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350 CEP 90035-003 Porto Alegre RS Brazil. Electronic address: francisconi@yahoo.com.
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Francisconi
authors.affiliation: PhD, Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575 Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Fukudo
authors.affiliation: Adjunct Clinical Professor, and Director of the Advanced Specialization Program in Couple and Family Therapy at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis; Faculty, Mount Sinai School of Medicine, Division of Gastroenterology.
authors.forename: Mary-Joan
authors.initials: MJ
authors.lastname: Gerson
authors.affiliation: Parkside Hospital, 53 Parkside, London, SW17 5NX, United Kingdom.
authors.forename: Jin-Yong
authors.initials: JY
authors.lastname: Kang
authors.affiliation: MD, Professor of Medicine, Laboratorio de Hígado, Páncreas y Motilidad (HIPAM)-Unit of Research in Experimental Medicine, Faculty of Medicine-Universidad Nacional Autónoma de México (UNAM), Hospital General de México, Dr. Balmis #148, Col. Doctores C.P.06726, México D.F.-México.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Schmulson W
authors.affiliation: Emeritus Professor of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ami D
authors.initials: AD
authors.lastname: Sperber
keywords: Culture; cross-cultural competence; cross-cultural factors; cross-cultural research; explanatory model; food and food taboos; symptom interpretation