Gas-related symptoms, experienced by 80% of adults, negatively affect quality of life
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A survey across two continents showed that just 11% of adults could report a lack of gas-related symptoms during a 24-hour period.
According to a presenter at UEG Week Virtual, the presence of those symptoms correlate with anxiety, depression and non-gastrointestinal physical symptoms.
“The striking thing about our findings is that nearly all adults in the general population experience some daily gas-related symptoms and this affects predominantly people under age 50,” Olafur S. Palsson, PsyD, professor of medicine at the UNC School of Medicine, said during a press conference.
Palsson and colleagues surveyed 5,978 adults from the United States (n = 1,996), the United Kingdom (n = 1,994) and Mexico (n = 1,988), aged 18 to 99 years. They filled out validated intestinal gas questionnaires (IGQs) online and measured the presence and severity of seven gas-related symptoms during the past 24 hours and reported BMI, exercise, emotional well-being and quality of life during the past 7 days.
“These are common symptoms, by they are not studied as much as many other GI symptoms. But if they are frequent or severe, they might be indicative of GI health problems, and equally as importantly, they can really impair people’s well-being,” Palsson said.
The most common symptom reported was flatulence (81.3%; 95% CI, 80.3-82.6), but all other symptoms remained prominent: stomach rumbling (60.5%; 95% CI, 59.2-61.7), belching (58%; 95% CI, 56.7-59.3), bad breath (48.1%; 95% CI, 46.8-49.3), difficult gas evacuation (47.2%; 95% CI, 45.9-48.5), abdominal distension (39.6%; 95% CI, 38.3-40.8), and bloating or abdominal pressure (38.5%; 95% CI, 37.3-39.7). Only 11.1% of respondents reported no gas symptoms during the previous 24 hours while, on average, participants reported three different gas symptoms during that same period.
Although U.S. and U.K. respondents were similar in their breakdowns, Palsson showed that respondents in Mexico had higher rates of these gas-related symptoms. The total IGQ score for the U.S. was 14.5 and for the U.K. was 13.7, but the total score for Mexico was 26 (P < .001). The significance presented in each symptom individually as well.
Additionally, the women in Mexico reported a higher burden than their male counterparts with a score of 30.1 vs. 22 (P < .001). This sex differentiation was not seen in U.S. and U.K. respondents.
“That suggests that there are other factors between countries that are different and directly affecting that. They could be cultural, linguistic in how people understand these symptoms. It could be diet. We don’t know that yet,” Palsson said. A subset of respondents also reported diet, and the researchers will be analyzing that data.
The researchers showed that higher IGQ scores correlated with lower physical (r = –0.46) and mental (r = –0.33) quality of life scores as measured by the PROMIS Global-10 questionnaire.
Respondents also reported greater stress (r = 0.43), anxiety (r = 0.43), depression (r = 0.44) and non-GI symptoms (r = 0.5). BMI did not correlate with quality of life, and exercise had only a modest association.
“As we expected, gas-related symptoms are related to quality of life impairment and overall well-being,” Palsson said. “Overall, well-being in terms of your functioning and how you feel physically and mentally is affected by these symptoms. Individuals who had more of these gas-related symptoms had higher stress, anxiety symptoms, depression symptoms and non-GI symptoms like headache and back pain.”
Perspective
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Saleem Chowdhry, MD
This is interesting data from a multinational survey. Bloating and flatulence are major symptoms in functional GI disorders, and usually cause the most distress. However, the strikingly high prevalence of flatulence in a younger population raises important questions regarding diet and prevalence of functional GI disorders in this group. If the survey was done during the COVID-19 pandemic, it may raise the question of possible associations with COVID-19.
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Palsson OS. P0591. Presented at: UEG Week; Oct. 3-5, 2021 (virtual meeting).
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