American Journal of Epidemiology Vol. 136, No. 2: 165-177
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Onset and Disappearance of Gastrointestinal Symptoms and Functional Gastrointestinal Disorders
1Division of Gastroenterdogy and Internal Medicine, Mayo Clinic and Foundation Rochester, MN
2Department of Health Sciences Research, Mayo Clinic and Foundation Rochester, MN
Reprint requests to Dr. Nicholas J. Tafley, Gastroenterology Unit, Mayo Clinic, Rochester, MN 55905
Functional gastrointestinal disorders, including the irritable bowel syndrome, account for up to 40% of referrals to gastroenterologists, but accurate data on the natural history of these disorders in the general population are lacking. Using a reliable and valid questionnaire, the authors estimated the onset and disappearance of symptoms consistent with functional gastrointestinal disorders. An age- and sex-strattfied random sample of 1,021 eligible residents of Olmsted County, Minnesota, aged 30–64 years were initially mailed the questionnaire; 82% responded (n = 835). In a remailing to responders 12–20 months later, 83% responded again (n = 690). The age- and sex-adjusted prevalence rates per 100 for irritable bowel syndrome, chronic constipation, chronic diarrhea, and frequent dyspepsia were 18.1 (95% confidence interval (Cl) 15.1–21.1), 14.7 (95% Cl 11.9–17.4), 7.3 (95% Cl 5.3–9.3), and 14.1 (95% Cl 11.5–16.8), respectively, on the second mailing. Symptoms were not significantly associated with nonresponse to the second mailing; moreover, the estimated prevalence rates were not significantly different from the first mailing. Among the 582 subjects free of the irritable bowel syndrome on the first survey, 9% developed symptoms during 795 person-years of follow-up, while 38% of the 108 who initially had the irritable bowel syndrome did not meet the criteria after 146 person-years of follow-up. Similar onset and disappearance rates were observed for the other main symptom categories. While functional gastrointestinal symptoms are common in middle-aged persons and overall prevalence appears relatively stable over 12–20 months, substantial turnover is implied by the observed onset and disappearance rates; several potential sources of bias do not seem to account for this variation. Am J Epidemiol 1992;136:165–77.
cdonic diseases, functional; constipation; diarrhea; dyspepsia; gastroenterology; gastroesophageal; reflux; prevalence; questionnaires
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