Increasing GI Symptoms Seen in Approximately One-Third of Young Adults

stomach pain
Investigators sought to identify common GI symptoms in a large sample of “emerging adults” using the Patient-Reported Outcomes Measurement Information System – GI (PROMIS-GI) symptom scales.

Approximately one-third of young adults aged 18 to 25 years were found to experience at least 1 gastrointestinal (GI) symptom above normal levels. These survey findings, published in BMC Gastroenterology, suggest that mild to moderate GI symptoms indicative of bowel disorders appear to present at much younger ages and at a greater frequency than previously documented, the authors said.

The investigators recruited 956 students enrolled in introductory psychology courses at the University of Central Florida. Participants responded to a 198-question online survey, made available from May 2018 to December 2018, which included assessments from the Patient-Reported Outcomes Measurement Information System-GI (PROMIS-GI), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Screener (GAD-7), Short Form Health Survey (SF-36), and Validity Check (VCheck).

The respondents’ mean age was 19 years (standard deviation [SD], 1.5), 58.3% were women, 57.3% were White, and 65.8% had a body mass index between 18.5 and 24.9.

Approximately one-third (36.4%) of respondents experienced at least 1 GI symptom the week before the survey became available. The reported symptoms were gas or bloating (36.4%), nausea or vomiting (26.9%), belly pain (21.6%), constipation (11.7%), diarrhea (8.9%), and heartburn or reflux (6.8%).

The researchers found that the best fit model for the reported GI symptoms was a 3-class model that separated participants into normal (67.89%), mild (26.88%), and moderate (5.2%) groups. The principal differentiator among classes was symptom severity.

Individuals in the mild group were likely preclinical for a bowel disorder as they reported 3 symptoms with a 0.5-SD severity above the study population’s mean score. Individuals in the moderate group were likely in the clinical range for a bowel disorder because they reported 4 symptoms with a 1.0-SD severity above the mean score.

The mild and moderate classes together reported the highest symptom elevations for gas or bloating, nausea or vomiting, and belly pain. These symptoms were generally consistent with an irritable bowel syndrome diagnosis (mixed or unclassified), but the rate of nausea or vomiting was higher than expected for a typical diagnosis.

Stratifying participants by their GI symptom classes, the investigators observed significant differences for their PHQ-9 scores (F, 47.924; h2, 0.092; P <.001), GAD-7 scores (F, 54.438; h2, 0.103; P <.001), and SF-36 scales for physical function (F, 5.013; h2, 0.010; P <.01), energy (F, 40.40; h2, 0.078; P <.001), emotional well-being (F, 42.205; h2, 0.081; P <.001), social function (F, 45.759; h2, 0.088; P <.001), pain (F, 66.402; h2, 0.122; P <.001), and general health (F, 42.971; h2, 0.083; P <.001).

The results from this study may not be generalizable to the general population because they were derived from a university setting, but the findings warrant further study of this population’s GI health, the authors said.

“It is recommended that health service providers evaluate individual patterns of ‘GI health’ when young adults present with anxiety and depression, and conversely, they should assess anxiety and depression when they present with GI complains,” they concluded.

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Vivier H, Ross EJ, and Cassisi JE. Classification of gastrointestinal symptom patterns in young adults. BMC Gastroenterol. 2020;20(1):326.  doi:10.1186/s12876-020-01478-7