Chronic, unexplained gastrointestinal disorders may be due to underlying pathogeneses. These findings, from a prospective, population-based study were published in the Mayo Clinic Proceedings.

Self-reported questionnaires from individuals recruited in Olmsted County in the United States between 1990 and 2009 were analyzed in this study. The participants were surveyed 3 times (1990-1992: n=1535, 2003-2004: n=2256, 2008-2009: n=3803) over the study period using the Talley Bowel Disease Questionnaire.

Participants were aged mean 43±13 years at the time of the first survey and 61±16 years at the third. Between 51% and 54% were women. Among all survey recipients, older individuals were more likely to complete the questionnaires (P =.007).

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Around 50% of respondents had no gastrointestinal symptoms. The individuals who reported symptoms indicated they were relatively stable over time, except dysphagia, which increased from 7% to 14%. During the first, second, and third surveys 19%, 25%, and 21% indicated they had esophageal disorders, 12%, 10%, and 10% had gastroduodenal disorders, and 45%, 40%, and 37% had bowel disorders, respectively.

Among the 228 individuals who responded to all 3 surveys, 25% had no symptoms and 4% consistently reported the same symptoms, indicating transitions of gastrointestinal symptoms were common (P <.001).

Among the individuals who had no symptoms during the first survey, 19% developed lower gastrointestinal, 9% upper gastrointestinal, and 4% both upper and lower symptoms in later surveys.

For the individuals who reported gastroesophageal reflux disease during the first survey, 49% had other symptoms, 29% still had the same symptoms, and 23% had no symptoms during the last survey. The individuals who reported dyspepsia during the first survey transitioned to other symptoms (54%), had the same symptoms (12%), or had no symptoms (35%) during the last survey. Among those who reported irritable bowel syndrome, 60% developed other symptoms and 24% had no symptoms over time.

Among all study participants, 32% had consistent symptoms, 29% never reported symptoms, 23% had resolution of symptoms, and 17% developed symptoms.

High symptom severity scores were associated with increased risk for having consistent symptoms (odds ratio [OR], 12.7; 95% CI, 4.62-34.90) and symptom transition (OR, 3.9; 95% CI, 1.38-10.77) over time.

The results of this study may not be generalizable because Olmsted County, the surveyed population, has a lack of ethnic diversity (82.5% White).

These data indicated some unexplained gastrointestinal disorders appeared to be stable among the population for decades and about a quarter of individuals had resolution of symptoms with time.


Choung R S, Saito Y A, Schleck C D, et al. The natural history of chronic unexplained gastrointestinal disorders and gastroesophageal reflux during 20 years: a US population-based study. Mayo Clin Proc. 2021;96(3):563-576. doi: 10.1016/j.mayocp.2020.08.043