title: Symptom burden and consulting behavior in patients with overlapping functional disorders in the US population.
abstract: BACKGROUND
  Regulatory and treatment guidelines focus on individual conditions, yet clinicians often see patients with overlapping conditions.
  
  
  OBJECTIVE
  This cross-sectional survey study assesses the impact of overlapping functional dyspepsia (FD), gastroesophageal reflux disease (GERD), irritable bowel syndrome with constipation (IBS-C), and chronic idiopathic constipation (CIC) on symptom burden and consulting behavior.
  
  
  METHODS
  Survey participants met Rome III criteria for FD, IBS-C, and/or CIC, and/or reported GERD; participants answered questions about symptom frequency and bothersomeness, work and productivity, and consulting behavior.
  
  
  RESULTS
  Of 2641 respondents, 1592 (60.3%) had one condition; 832 (31.5%) had two; and 217 (8.2%) had three; 57.3% of 1690 FD, 54.6% of 1337 GERD, 82.6% of 328 IBS-C, and 62.5% of 552 CIC respondents had condition overlap. Overall GI symptoms were very/extremely bothersome in 28.6% of single-condition respondents, 50.7% of two-condition, and 69.6% of three-condition respondents (p < 0.001, chi square). Symptom frequency and productivity losses both increased with condition overlap. Over 12 months, 43.7% of single-condition, 49.9% of two-condition, and 66.5% of three-condition respondents consulted a physician about GI symptoms (p < 0.001, chi square).
  
  
  CONCLUSIONS
  Functional GI disorders frequently overlap with each other and with GERD. Condition overlap is associated with greater symptom burden and increased physician consultations.
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Nimish
authors.initials: N
authors.lastname: Vakil
authors.affiliation: Ironwood Pharmaceuticals, Cambridge MA, USA.
authors.forename: Margie
authors.initials: M
authors.lastname: Stelwagon
authors.affiliation: Ironwood Pharmaceuticals, Cambridge MA, USA.
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Shea
authors.affiliation: Lieberman Inc, Great Neck, NY, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Miller
keywords: FD; GERD; IBS; IBS-C; Irritable bowel syndrome with constipation; chronic idiopathic constipation; functional dyspepsia; gastroesophageal reflux disease