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Prevalence, symptom patterns and management of episodic diarrhoea in the community: a population‐based survey in 11 countries
Author(s) -
Hungin A. P. S.,
Paxman L.,
Koenig K.,
Dalrymple J.,
Wicks N.,
Walmsley J.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13513
Subject(s) - medicine , population , environmental health , diarrhea , developing country , medline , family medicine , economic growth , political science , law , economics
Summary Background The extent of episodic diarrhoea in the community is relatively unknown. Aim To ascertain the prevalence, symptoms and management behaviours associated with self‐reported diarrhoea across 11 countries. Methods Community screening surveys were conducted using quota sampling of respondents to identify a nationally representative sample of individuals suffering from ‘episodic’ diarrhoea (occurring once a month or more often). Second‐phase in‐depth surveys provided data on epidemiology, symptoms, attributed causes and management of episodic diarrhoea. Results A total of 11 508 phase 1 and 6613 phase 2 surveys were completed. The prevalence of self‐reported episodic diarrhoea ranged from 16% to 23% across the 11 countries. The majority of episodic diarrhoea sufferers were female (57%) and were not diagnosed with pre‐existing irritable bowel syndrome ( IBS ); IBS diagnosis ranged from 9% in Mexico to 44% in Italy. Diarrhoea was frequently attributed to anxiety/stress, food‐related causes, gastrointestinal ‘sensitivity’ and menstruation. Accompanying symptoms included ‘stomach pain/cramping’ (35–62%), ‘stomach grumbling’ (29–68%) and ‘wind’ (18–74%). The proportion of episodic sufferers who reported treating their symptoms with remedies or medications ranged between 46% in Belgium and Canada and 90% in Mexico. Conclusions A substantial proportion of the population in middle‐ to high‐income countries report episodic diarrhoea in the absence of a pre‐existing diagnosis. These symptoms are likely to be associated with substantial social and economic costs, and have implications on how best to configure and guide self‐led, pharmacist‐led and primary care management.