Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters

Kewin Tien Ho Siah, Xiaorong Gong, Xi Jessie Yang, William E. Whitehead, Minhu Chen, Xiaohua Hou, Nitesh Pratap, Uday C. Ghoshal, Ari F. Syam, Murdani Abdullah, Myung Gyu Choi, Young-Tae Bak, Ching Liang Lu, Sutep Gonlachanvit, Chua Seng Boon, Fan Fang, Pui Kuan Cheong, Justin C.Y. Wu, Kok Ann Gwee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: Functional gastrointestinal disorders (FGIDs) are diagnosed by the presence of a characteristic set of symptoms. However, the current criteria-based diagnostic approach is to some extent subjective and largely derived from observations in English-speaking Western patients. We aimed to identify latent symptom clusters in Asian patients with FGID.Design: 1805 consecutive unselected patients with FGID who presented for primary or secondary care to 11 centres across Asia completed a cultural and linguistic adaptation of the Rome III Diagnostic Questionnaire that was translated to the local languages. Principal components factor analysis with varimax rotation was used to identify symptom clusters.Results: Nine symptom clusters were identified, consisting of two oesophageal factors (F6: globus, odynophagia and dysphagia; F9: chest pain and heartburn), two gastroduodenal factors (F5: bloating, fullness, belching and flatulence; F8 regurgitation, nausea and vomiting), three bowel factors (F2: abdominal pain and diarrhoea; F3: meal-related bowel symptoms; F7: upper abdominal pain and constipation) and two anorectal factors (F1: anorectal pain and constipation; F4: diarrhoea, urgency and incontinence).Conclusion: We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings.

Original languageEnglish
JournalGut
DOIs
Publication statusAccepted/In press - 2017 Jun 7

Fingerprint

Gastrointestinal Diseases
Constipation
Diarrhea
Abdominal Pain
Meals
Eructation
Flatulence
Secondary Care
Heartburn
Linguistics
Deglutition Disorders
Principal Component Analysis
Chest Pain
Nausea
Statistical Factor Analysis
Vomiting
Primary Health Care
Language
Gases
Pain

Keywords

  • Asia
  • Digestive symptoms
  • Factor analysis
  • Functional gastrointestinal disorders

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Siah, K. T. H., Gong, X., Yang, X. J., Whitehead, W. E., Chen, M., Hou, X., ... Gwee, K. A. (Accepted/In press). Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters. Gut. https://doi.org/10.1136/gutjnl-2016-312852

Rome Foundation-Asian working team report : Asian functional gastrointestinal disorder symptom clusters. / Siah, Kewin Tien Ho; Gong, Xiaorong; Yang, Xi Jessie; Whitehead, William E.; Chen, Minhu; Hou, Xiaohua; Pratap, Nitesh; Ghoshal, Uday C.; Syam, Ari F.; Abdullah, Murdani; Choi, Myung Gyu; Bak, Young-Tae; Lu, Ching Liang; Gonlachanvit, Sutep; Boon, Chua Seng; Fang, Fan; Cheong, Pui Kuan; Wu, Justin C.Y.; Gwee, Kok Ann.

In: Gut, 07.06.2017.

Research output: Contribution to journalArticle

Siah, KTH, Gong, X, Yang, XJ, Whitehead, WE, Chen, M, Hou, X, Pratap, N, Ghoshal, UC, Syam, AF, Abdullah, M, Choi, MG, Bak, Y-T, Lu, CL, Gonlachanvit, S, Boon, CS, Fang, F, Cheong, PK, Wu, JCY & Gwee, KA 2017, 'Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters', Gut. https://doi.org/10.1136/gutjnl-2016-312852
Siah, Kewin Tien Ho ; Gong, Xiaorong ; Yang, Xi Jessie ; Whitehead, William E. ; Chen, Minhu ; Hou, Xiaohua ; Pratap, Nitesh ; Ghoshal, Uday C. ; Syam, Ari F. ; Abdullah, Murdani ; Choi, Myung Gyu ; Bak, Young-Tae ; Lu, Ching Liang ; Gonlachanvit, Sutep ; Boon, Chua Seng ; Fang, Fan ; Cheong, Pui Kuan ; Wu, Justin C.Y. ; Gwee, Kok Ann. / Rome Foundation-Asian working team report : Asian functional gastrointestinal disorder symptom clusters. In: Gut. 2017.
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abstract = "Objective: Functional gastrointestinal disorders (FGIDs) are diagnosed by the presence of a characteristic set of symptoms. However, the current criteria-based diagnostic approach is to some extent subjective and largely derived from observations in English-speaking Western patients. We aimed to identify latent symptom clusters in Asian patients with FGID.Design: 1805 consecutive unselected patients with FGID who presented for primary or secondary care to 11 centres across Asia completed a cultural and linguistic adaptation of the Rome III Diagnostic Questionnaire that was translated to the local languages. Principal components factor analysis with varimax rotation was used to identify symptom clusters.Results: Nine symptom clusters were identified, consisting of two oesophageal factors (F6: globus, odynophagia and dysphagia; F9: chest pain and heartburn), two gastroduodenal factors (F5: bloating, fullness, belching and flatulence; F8 regurgitation, nausea and vomiting), three bowel factors (F2: abdominal pain and diarrhoea; F3: meal-related bowel symptoms; F7: upper abdominal pain and constipation) and two anorectal factors (F1: anorectal pain and constipation; F4: diarrhoea, urgency and incontinence).Conclusion: We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings.",
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AU - Gong, Xiaorong

AU - Yang, Xi Jessie

AU - Whitehead, William E.

AU - Chen, Minhu

AU - Hou, Xiaohua

AU - Pratap, Nitesh

AU - Ghoshal, Uday C.

AU - Syam, Ari F.

AU - Abdullah, Murdani

AU - Choi, Myung Gyu

AU - Bak, Young-Tae

AU - Lu, Ching Liang

AU - Gonlachanvit, Sutep

AU - Boon, Chua Seng

AU - Fang, Fan

AU - Cheong, Pui Kuan

AU - Wu, Justin C.Y.

AU - Gwee, Kok Ann

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N2 - Objective: Functional gastrointestinal disorders (FGIDs) are diagnosed by the presence of a characteristic set of symptoms. However, the current criteria-based diagnostic approach is to some extent subjective and largely derived from observations in English-speaking Western patients. We aimed to identify latent symptom clusters in Asian patients with FGID.Design: 1805 consecutive unselected patients with FGID who presented for primary or secondary care to 11 centres across Asia completed a cultural and linguistic adaptation of the Rome III Diagnostic Questionnaire that was translated to the local languages. Principal components factor analysis with varimax rotation was used to identify symptom clusters.Results: Nine symptom clusters were identified, consisting of two oesophageal factors (F6: globus, odynophagia and dysphagia; F9: chest pain and heartburn), two gastroduodenal factors (F5: bloating, fullness, belching and flatulence; F8 regurgitation, nausea and vomiting), three bowel factors (F2: abdominal pain and diarrhoea; F3: meal-related bowel symptoms; F7: upper abdominal pain and constipation) and two anorectal factors (F1: anorectal pain and constipation; F4: diarrhoea, urgency and incontinence).Conclusion: We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings.

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KW - Digestive symptoms

KW - Factor analysis

KW - Functional gastrointestinal disorders

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