Velarde-Ruiz VJA, Morales-Arambúla M, Coss-Adame E, Gómez-Escudero O, Flores-Rendón R, Vázquez-Elizondo G, Carmona-Sánchez RI, Icaza-Chavéz ME, Tamayo-de la Cuesta JL, Huerta-Iga F, Tapia-Calderón DK, García-Jiménez ES, Morel-Cerda EC, García-Zermeño KR, Remes-Troche JM

Language: Spanish
References: 20
Page: 106-112
PDF size: 609.86 Kb.

ABSTRACT

Introduction. Functional gastrointestinal disorders (FGIDs) are recognized as a group of diseases with altered gut-brain interaction but without organic abnormality. FGIDs are the most common diagnoses in gastroenterology consults. It is frequent to find patients that cannot be englobed in one FGID, namely overlap of these disorders. Research studies of the epidemiological behavior of these overlaps are very important to develop therapeutic targets that improve morbidity of these disorders. The aim of this study was to know the prevalence of overlap FGIDs in patients that attended a specialty consultation in different states of the country.
Material and Methods. A descriptive, transversal study based on a survey about gastrointestinal symptoms in Mexico (SIGAME second version) was conducted. It consisted of an online questionnaire that included 184 items inquiring on clinical characteristics, resource utilization and prescription of patients attending consultation with 11 different Mexican gastroenterologists among 8 different states in Mexico. The objective was to recollect at least 1000 cases between January to May 2017.
Results. We included 925 patients, among who 71% were women. The final study population was 836. We found positive answers for gastroesophageal reflux disease (GERD) in 372 (44.4%) subjects; 247 individuals (29.5%) satisfied irritable bowel syndrome (IBS) criteria,finally, 87 patients (10.4%) fulfilled dyspepsia criteria. GERD-IBS complex was present in 106 patients; GERD-Dyspepsia was found in 68 subjects; and IBS-Dyspepsia was identified in 55 people. Finally, triple overlap (GERD-Dyspepsia-IBS) was found in 26 patients.
Discussion. In Mexico, it is frequent to find gastrointestinal symptoms overlap from different FGIDs. In this survey, the main FGID was GERD, which coexisted with another disease in nearly half of patients. A correct approach to individual gastrointestinal symptoms is important in order to define the best treatment strategy to lower the morbidity of FGIDs

REFERENCES

1. Drossman DA, Hasler W L. Rome IV-functional GI disorders: disorders of gut brain interaction. Gastroenterology 2016;150:1257–61.

2. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology 2016;150:1262–79.

3. Chang L. Review article: epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther 2004;20:31–9.

4. Talley NJ. Functional gastrointestinal disorders as a public health problem. Neurogastroenterol Motil 2008;20:121–9

5. Patel P, Ford AC. Irritable bowel syndrome and somatization. Neurogastroenterol Motil 2015;27:740.

6. Longstreth GF, Yao JF. Irritable bowel syndrome and surgery: amultiva riable analysis. Gastroenterology 2004;126:1665–73.

7. Hasler WL, Schoenfeld P. Systematic review: abdominal and pelvic surgery in patients with irritable bowel syndrome. Aliment Pharmacol Ther 2003;17:997–1005.

8. Talley NJ, Dennis EH, Schettler-Duncan VA,Lacy BE, Olden KW, Crowell MD. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol 2003;98(11):2454-9.

9. Locke GR, Zinsmeister AR, Fett SL, Melton LJ, Talley N. Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil. 2005;17(1):29-34.

10. Saito YA, Schoenfeld P, Locke GR. The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol 2002;97(8):1910-5.

11. Spiller R, Aziz Q, Creed F, Emmanuel A, Houghton L, Hungin P, et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut 2007;56(12):1770-9

12. Fullard M, Kang JY, Neild P,Poullis A, Maxwell JD. Systematic review: does gastrooesophageal reflux disease progress? Aliment Pharmacol Ther 2006;24(1):33-45.

13. Wong WM, Fass R. Extraesophageal and atypical manifestations of GERD. J Gastroenterol Hepatol 2004;19 Suppl 3:S33-43..

14. Zimmerman J. Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: nature, severity, and relationshipto gastrointestinals ym ptoms. Dig Dis Sci 2003;48(4):743-9.

15. Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut 2015;64:1049–57.

16. Gonlachanvit S, Maurer AH, Fisher RS,Parkman HP. Regional gastric emptying abnormalities infunctional dyspepsia and gastrooesophageal reflux disease. Neurogastroenterol Motil 2006;18:894–904.

17. Agreus L, Svardsudd K, Nyren O, Tibblin G. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology 1995;109:671-80.

18. Schmulson MJ, Remes-Troche JM, López- Alvarenga JC, Vargas JA, López-Colombo A, Crespo Y, et al. Rome III IBS-M subgroup is associated with increased severity of upper gastrointestinal symptoms. A report of the Mexican IBS working group. Neurogastroenterol Motil 2009;1(S1):69.

19. Gómez-Escudero O. Sobreposición de trastornos funcionales digestivos. En: Remes-Troche JM. Ed. Síntomas gastrointestinales en México. Un estudio epidemiológico. Sigame. Mexico: Asecom editores; 2015.

20. Lee KN. The clinical implications of overlap between constipation and common functional gastrointestinal disorders. J Neurogastroenterol Motil 2017;23(4)-485-6