Overlap of Disorders of Gut-Brain Interaction: Frequency, Somatization, Quality of Life, and Psychological Impact

Open Access

Abstract

Background: Disorders of gut-brain interaction (DGBI) often occur in multiple anatomical regions of the gastrointestinal tract, and this overlap has been associated with increased symptom severity and psychological impact. This study aimed to determine the prevalence and distribution of DGBI overlap and its relation to somatization, quality of life, and psychological parameters among patients attending a tertiary care hospital. Methods & Materials: This cross-sectional observational study was conducted at National Gastro liver Institute and Hospital, Mohakhali, Dhaka, from January 2023 to October 2023. All adult patients who met the Rome IV criteria for at least one DGBI were consecutively enrolled. The Patients with alarm features, organic gastrointestinal disease, or incomplete data were excluded. PHQ-15 was used to assess somatization, the PROMIS-10 for quality of life, and the PHQ-4 for anxiety/depression state. Patients were divided according to the number of anatomical regions of the GI tract involved. Data were entered and analyzed on SPSS version 26; a p<0.05 was considered statistically significant. Results: Of the 595 patients (mean age 34.81 ± 1.11 years; 67.1% male), the most prevalent subtype was functional dyspepsia (44.9%), followed by irritable bowel syndrome (29.2%), functional constipation (25.4%), and functional diarrhea (22%). Two-thirds of patients (66.6%) had overlap involving two or more anatomical regions. Somatization scores increased slightly with increasing regional overlap, and PROMIS-10 physical and mental health scores did not vary significantly across groups. The prevalence of depression significantly increased with overlap (17.1% to 26.7%), while the increase in anxiety prevalence was not significant. Conclusion: There is a high degree of anatomical overlap in this tertiary care cohort, and this is significantly correlated with worsening depressive symptoms, suggesting the importance of psychological screening in patients with multi-regional DGBI.