Skip to main content

Advertisement

SpringerLink
Log in

Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background/Purpose

There is scarcity of data on prevalence, overlap, and risk factors for functional gastrointestinal disorders (FGID) by Rome IV criteria. We evaluated these factors among medical, nursing, and humanities students.

Methods

Rome IV Diagnostic Questionnaire (for all FGIDs), Rome III questionnaire (for irritable bowel syndrome [IBS], functional diarrhea [FDr], and functional constipation [FC]), and questionnaires assessing demography, physical activity, anxiety, and depression were used.

Results

A total of 1309 college students were included (medical 425, nursing 390, humanities 494; mean age 20.5 ± 2.1 years; 36.5% males). Prevalence of Rome IV FGIDs was 26.9% (n = 352), significantly higher among females compared with males (32.3% vs. 17.6%; p < 0.001) and significantly higher among medical (34.4%) and nursing students (29.2%) compared with humanities students (18.6%) (p < 0.05). Most common FGIDs were functional dyspepsia (FD) (15.2%), IBS (6.2%), reflux hypersensitivity (3.5%), FDr (2.9%), FC (2.1%), and unspecified functional bowel disorder (2.1%). FGID overlap was present in 9.3%, most common being FD-IBS overlap (4.4%). With Rome III criteria, prevalence of IBS was higher (9.5%), while that of FDr (0.92%) and of FC (1.3%) were lower. On multivariate analysis, independent predictors for FGIDs were female gender, medical student, non-vegetarian diet, junk food, tea/coffee, poor physical activity, anxiety, and insomnia.

Conclusion

Rome IV FGIDs were present among one-fourth of college students with preponderance among females and medical students. FD, IBS, and reflux hypersensitivity were the most common FGIDs. Rome IV criteria led to a reduction in IBS prevalence and increase in FDr and FC prevalence. Dietary factors, physical activity, anxiety, and insomnia affected FGID prevalence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and rome IV. Gastroenterology. 2016:S0016–5085(16)00223–7.

  2. Mahadeva S, Ford AC. Clinical and epidemiological differences in functional dyspepsia between the east and the west. Neurogastroenterol Motil. 2016;28:167–74.

    Article  CAS  Google Scholar 

  3. Mearin F, Lacy BE, Chang L, et al. Bowel Disorders. Gastroenterology. 2016:S0016–5085(16)00222–5.

  4. Wu W, Guo X, Yang Y, et al. The prevalence of functional gastrointestinal disorders in the Chinese air force population. Gastroenterol Res Pract. 2013;2013:497585.

    PubMed  PubMed Central  Google Scholar 

  5. Nakajima S, Takahashi K, Sato J, et al. Spectra of functional gastrointestinal disorders diagnosed by Rome III integrative questionnaire in a Japanese outpatient office and the impact of overlapping. Gastroenterol Hepatol. 2010 May;25 Suppl 1:S138–43.

  6. Chuah KH, Mahadeva S. Cultural factors influencing functional gastrointestinal disorders in the east. J Neurogastroenterol Motil. 2018;24:536–43.

  7. Gwee KA, Gonlachanvit S, Ghoshal UC, et al. Second Asian consensus on irritable bowel syndrome. J Neurogastroenterol Motil. 2019;25:343–62.

  8. Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: a review. World J Gastroenterol. 2017;23:6788–801.

  9. Oshima T, Miwa H. Epidemiology of functional gastrointestinal disorders in Japan and in the world. J Neurogastroenterol Motil. 2015;21:320–9.

    Article  Google Scholar 

  10. Palsson OS, Whitehead W, Tornblom H, et al. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology. 2020;158:1262–73.

    Article  Google Scholar 

  11. Ghoshal UC, Singh R. Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population. J Gastroenterol Hepatol. 2017;32:378–87.

    Article  Google Scholar 

  12. Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001;20:103–6.

    CAS  PubMed  Google Scholar 

  13. Makharia GK, Verma AK, Amarchand R, et al. Prevalence of irritable bowel syndrome: a community based study from northern India. J Neurogastroenterol Motil. 2011;17:82–7.

    Article  Google Scholar 

  14. Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008;27:22–8.

    PubMed  Google Scholar 

  15. Basandra S, Bajaj D. Epidemiology of dyspepsia and irritable bowel syndrome (IBS) in medical students of northern India. J Clin Diagn Res. 2014;8:JC13–JC6.

    PubMed  PubMed Central  Google Scholar 

  16. Misra P, Upadhyay RP, Krishnan A, Sharma N, Kapoor SK. A community based study to test the reliability and validity of physical activity measurement techniques. Int J Prev Med. 2014;5:952–9.

  17. Wani FA, Almaeen AH, Bandy AH, et al. Prevalence and risk factors of IBS among medical and nonmedical students in the Jouf University. Niger J Clin Pract. 2020;23:555–60.

    CAS  PubMed  Google Scholar 

  18. Sarkar S, Gupta R, Menon V. A systematic review of depression, anxiety, and stress among medical students in India. J Ment Health Hum Behav. 2017;22:88–96.

    Google Scholar 

  19. Lovell RM, Ford AC. Effect of gender on prevalence of irritable bowel syndrome in the community: systematic review and meta-analysis. Am J Gastroenterol. 2012;107:991–1000.

    Article  Google Scholar 

  20. Kaji M, Fujiwara Y, Shiba M, et al. Prevalence of overlaps between GERD, FD and IBS and impact on health-related quality of life. J Gastroenterol Hepatol. 2010;25:1151–6.

    Article  Google Scholar 

  21. Suzuki H, Hibi T. Overlap syndrome of functional dyspepsia and irritable bowel syndrome - are both diseases mutually exclusive? J Neurogastroenterol Motil. 2011;17:360–5.

    Article  Google Scholar 

  22. Fang YJ, Liou JM, Chen CC, et al. Distinct aetiopathogenesis in sub-groups of functional dyspepsia according to the Rome III criteria. Gut. 2015;64:1517–28.

    Article  Google Scholar 

  23. Vakil N, Halling K, Ohlsson L, Wernersson B. Symptom overlap between postprandial distress and epigastric pain syndromes of the Rome III dyspepsia classification. Am J Gastroenterol. 2013;108:767–74.

    Article  Google Scholar 

  24. Fujiwara Y, Arakawa T. Overlap in patients with dyspepsia/functional dyspepsia. J Neurogastroenterol Motil. 2014;20:447–57.

    Article  Google Scholar 

  25. Lacy BE, Cangemi D, Vazquez-Roque M. Management of chronic abdominal distension and bloating. Clin Gastroenterol Hepatol. 2020:S1542–3565(20)30433-X.

  26. Siah KTH, Gong X, Yang XJ, et al. Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters. Gut. 2018;67:1071–7.

    Article  Google Scholar 

  27. Jiang X, Locke GR 3rd, Choung RS, Zinsmeister AR, Schleck CD, Talley NJ. Prevalence and risk factors for abdominal bloating and visible distention: a population-based study. Gut. 2008;57:756–63.

  28. Aziz I, Törnblom H, Palsson OS, Whitehead WE, Simrén M. How the change in IBS criteria from Rome III to Rome IV impacts on clinical characteristics and key pathophysiological factors. Am J Gastroenterol. 2018;113:1017–25.

  29. Chey WD. The role of food in the functional gastrointestinal disorders: introduction to a manuscript series. Am J Gastroenterol. 2013;108:694–7.

    Article  CAS  Google Scholar 

  30. Clegg ME, McKenna P, McClean C, et al. Gastrointestinal transit, postprandial lipaemia and satiety following 3 days high-fat diet in men. Eur J Clin Nutr. 2011;65:240–6.

  31. Cani PD, Everard A. Talking microbes: when gut bacteria interact with diet and host organs. Mol Nutr Food Res. 2016;60:58–66.

    Article  CAS  Google Scholar 

  32. Chouliaras G, Kondyli C, Bouzios I, Spyropoulos N, Chrousos GP, Roma-Giannikou E. Dietary habits and abdominal pain-related functional gastrointestinal disorders: a school-based, cross-sectional analysis in Greek children and adolescents. J Neurogastroenterol Motil. 2019;25:113–22.

  33. Shau JP, Chen PH, Chan CF, et al. Fast foods - are they a risk factor for functional gastrointestinal disorders? Asia Pac J Clin Nutr. 2016;25:393–401.

    PubMed  Google Scholar 

  34. Müller-Lissner SA, Kaatz V, Brandt W, Keller J, Layer P. The perceived effect of various foods and beverages on stool consistency. Eur J Gastroenterol Hepatol. 2005;17:109–12.

  35. Gibson PR, Shepherd SJ. Food choice as a key management strategy for functional gastrointestinal symptoms. Am J Gastroenterol. 2012;107:657–66.

    Article  CAS  Google Scholar 

  36. Babu J, Kumar S, Babu J, et al. Frequency of lactose malabsorption among healthy southern and northern Indian populations by genetic analysis and lactose hydrogen breath and tolerance tests. Am J Clin Nutr. 2010;91:140–6.

  37. Singh A, Singh S. Dietary fibre content of Indian diets. Asian J Pharm Clin Res. 2015;8:58–61.

    CAS  Google Scholar 

  38. Kundur R, Lingala KV, Alrshedi AR. A study on the effect of dietary factors on functional gastrointestinal disorders in women of HA’IL region in Saudi Arabia. Asian J Pharm Clin Res. 2018;11:202–7.

    Article  Google Scholar 

  39. Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol. 2011;106:915–22.

  40. Futagami S, Yamawaki H, Izumi N, et al. Impact of sleep disorders in Japanese patients with functional dyspepsia (FD): nizatidine improves clinical symptoms, gastric emptying and sleep disorders in FD patients. J Gastroenterol Hepatol. 2013;28:1314–20.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

Mr. Harsh Kishore and Ms. Jaskirat Kaur for data entering, analyzing, and typewriting the manuscript.

Funding

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, 141 001, India

    Omesh Goyal, Sahil Nohria, Rajoo Singh Chhina & Ajit Sood

  2. Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, 141 001, India

    Armaan Singh Dhaliwal & Prerna Goyal

  3. Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, 141 001, India

    Ravinder Kumar Soni

Authors
  1. Omesh Goyal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sahil Nohria
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Armaan Singh Dhaliwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Prerna Goyal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ravinder Kumar Soni
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rajoo Singh Chhina
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ajit Sood
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Omesh Goyal.

Ethics declarations

Conflict of interest

OG, SN, ASD, PG, RKS, RSC, and AS declare that they have no conflict of interest.

Ethics statement

The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

The questionnaire and methodology for this study were approved by the institutional ethics committee (DMCH/R&D/2018/675). All procedures performed were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki Declaration and its later amendments.

Disclaimer

The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology, or the printer/publishers are responsible for the results/findings and content of this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Goyal, O., Nohria, S., Dhaliwal, A.S. et al. Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India. Indian J Gastroenterol 40, 144–153 (2021). https://doi.org/10.1007/s12664-020-01106-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-020-01106-y

Keywords

Search

Navigation