Around 11% of the global population (13% of women and 9% of men) frequently experience abdominal pain when they eat meals, according to a survey on over 50,000 people. The research is being presented for the first time today at UEG Week Virtual 2021.[1]
Pain associated with eating appears to be most common in young people aged 18 to 28, with 15% affected, the research found.
Those who experienced frequent abdominal meal-related pain were also more likely to suffer from bloating, a swollen tummy, feeling too full after eating or feeling full up too quickly, constipation, and diarrhea. The same group also had more severe psychological distress and somatic symptoms (that were not gastrointestinal).
A total of 36% of the people with frequent meal-related pain reported suffering from anxiety compared with 25% in the occasional symptoms group and 18 % in those who never experienced meal-related pain. Those with frequent attacks also reported higher rates of depression (35%) compared to 24% in the occasional symptom group and 17% in the group that never had meal-related pain.
Based on the Rome Foundation Global Epidemiology study,[2] the findings were a result of surveying 54,127 people across 26 countries online. Respondents were asked if they suffered abdominal pain and whether this was related to eating. They were categorized into three groups: those who said their abdominal pain was meal-related more than 50% of the time, those who had occasional meal-related pain between 10-40% of the time, and those who rarely or never had meal-related pain.
Meal-Related Pain Linked to Broader Gut-Brain Disorders
Esther Colomier, study author and a joint PhD researcher at KU Leuven, Belgium, and the University of Gothenburg, Sweden, explained, “The take home message from this study is that people who experience meal-related abdominal pain more frequently experience other gastrointestinal symptoms and more regularly fulfill criteria for disorders of the gut-brain interactions (DGBIs, formerly known as functional gut disorders), including common conditions such as irritable bowel syndrome (IBS), bloating and abdominal distension.”
“They also have a higher burden of psychological and somatic symptoms, such as back pain or shortness of breath, which are associated with major distress and functioning problems. These symptoms cause distress and disruption in daily life”, she added.
Lower gastrointestinal symptoms such as constipation and diarrhea were experienced in 30% of those who reported frequent meal-related pain, versus 20% in the group who reported occasional symptoms and 10 % in the no symptoms at all group. The same applied for bloating and abdominal distension symptoms, which were reported as often as once a week in the group who experienced frequent meal pain, compared to two or three days a month in the group with occasional pain and one day a month in the group who experienced no symptoms.
Clinical Implications: Toward Multidisciplinary Care
Esther Colomier concluded, “Considering meal-related symptoms in future diagnostic criteria for DGBIs should be encouraged. In clinical practice, assessing meal association in all patients with DGBIs could be of major importance for improving and individualizing treatment. Here, patients could benefit from a multidisciplinary care approach, including dietary and lifestyle advice, psychological support and pharmacological therapy.
Professor Ami Sperber, lead author of the 2021 Global Epidemiology Study of Functional Gastrointestinal Disorders (FGIDs),[2] which found 40% of people worldwide have FGIDs or disorders of the gut/ brain axis, said the findings of Ms Colomier’s study were of great interest.
“Many patients with disorders of gut-brain interactions (DGBI) such as irritable bowel syndrome and functional dyspepsia ascribe their symptoms to food and eating”, Professor Sperber explained. “A major complaint is the development of pain following meals. However, there are no substantive data on this phenomenon, despite its potential significance for patient care and the study of the pathophysiology of these disorders.”
“This research is the first to use the large database of the Rome Foundation Global Epidemiology Study to gain insight into meal-related abdominal pain and its significance. The authors’ analyses of this database enabled an assessment of meal-related pain in over 20 DGBI in terms of diagnosis and potential associations with variables related to socio-demographic factors, psychosocial variables, and other variables.”
“This has allowed Esther Colomier and her team to present a comprehensive picture of meal-related abdominal pain, its prevalence, societal burden, and its effect on the quality of life of patients with these very prevalent disorders.”
References:
“Global prevalence of meal-related pain and its relevance in disorders of gut-brain interaction” by Esther Colomier, Chloé Melchior, Joost P Algera, Jóhann P Hreinsson, Stine Störsrud, Hans Törnblom, Lukas Van Oudenhove, Olafur S Palsson, Shrikant I Bangdiwala, Ami D Sperber, Jan Tack and Magnus Simrén, 17 February 2022, BMC Medicine.
DOI: 10.1186/s12916-022-02259-7
“Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study” by Schmulson, Peter Whorwell, Timothy Archampong, Payman Adibi, Viola Andresen, Marc A Benninga, Bruno Bonaz, Serhat Bor, Luis Bustos Fernandez, Suck Chei Choi, Enrico S Corazziari, Carlos Francisconi, Albis Hani, Leonid Lazebnik, Yeong Yeh Lee, Agata Mulak, M Masudur Rahman, Javier Santos, Mashiko Setshedi, Ari Fahrial Syam, Stephen Vanner, Reuben K Wong, Aurelio Lopez-Colombo, Valeria Costa, Ram Dickman, Motoyori Kanazawa, Ammar Hassanzadeh Keshteli, Rutaba Khatun, Iradj Maleki, Pierre Poitras, Nitesh Pratap, Oksana Stefanyuk, Sandie Thomson, Judith Zeevenhooven and Olafur S Palsson, January 2021, Gastroenterology.
DOI: 10.1053/j.gastro.2020.04.014
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