DOI QR코드

DOI QR Code

Cultural Factors Influencing Functional Gastrointestinal Disorders in the East

  • Chuah, Kee-Huat (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya) ;
  • Mahadeva, Sanjiv (Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya)
  • Received : 2018.04.06
  • Accepted : 2018.07.21
  • Published : 2018.10.30

Abstract

Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functional gastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptom presentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functional dyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.

Keywords

References

  1. Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P. Effect of dyspepsia on survival: a longitudinal 10-year follow-up study. Am J Gastroenterol 2012;107:912-921. https://doi.org/10.1038/ajg.2012.69
  2. Chang JY, Locke GR 3rd, McNally MA et al. Impact of functional gastrointestinal disorders on survival in the community. Am J Gastroenterol 2010;105:822-832. https://doi.org/10.1038/ajg.2010.40
  3. Mahadeva S, Yadav H, Everett SM, Goh KL. Economic impact of dyspepsia in rural and urban malaysia: a population-based study. J Neurogastroenterol Motil 2012;18:43-57. https://doi.org/10.5056/jnm.2012.18.1.43
  4. Mahadeva S, Ford AC. Clinical and epidemiological differences in functional dyspepsia between the east and the west. Neurogastroenterol Motil 2016;28:167-174. https://doi.org/10.1111/nmo.12657
  5. El-Serag HB, Talley NJ. Health-related quality of life in functional dyspepsia. Aliment Pharmacol Ther 2003;18:387-393. https://doi.org/10.1046/j.1365-2036.2003.01706.x
  6. Van Oudenhove L, Levy RL, Crowell MD, et al. Biopsychosocial aspects of functional gastrointestinal disorders: how central and environmental processes contribute to the development and expression of functional gastrointestinal disorders. Gastroenterology 2016;150:1355-1367, e2. https://doi.org/10.1053/j.gastro.2016.02.027
  7. Francisconi CF, Sperber AD, Fang X, et al. Multicultural aspects in functional gastrointestinal disorders (FGIDs). Gastroenterology 2016;150:1344-1354, e2. https://doi.org/10.1053/j.gastro.2016.02.013
  8. Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: a review. World J Gastroenterol. 2017;23:6788-6801. https://doi.org/10.3748/wjg.v23.i37.6788
  9. Lee JY, Kim N, Kim GH, Kim GH. Comparing the areas of interest in the field of functional gastrointestinal disorder and neurogastroenterology and motility between the east and the west. J Neurogastroenterol Motil 2015;21:503-510. https://doi.org/10.5056/jnm15060
  10. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterology 2016;150:1262-1279, e2. https://doi.org/10.1053/j.gastro.2016.02.032
  11. Miwa H, Ghoshal UC, Fock KM, et al. Asian consensus report on functional dyspepsia. J Gastroenterol Hepatol 2012;27:626-641. https://doi.org/10.1111/j.1440-1746.2011.07037.x
  12. Fang YJ, Liou JM, Chen CC, et al. Distinct aetiopathogenesis in subgroups of functional dyspepsia according to the Rome III criteria. Gut 2015;64:1517-1528. https://doi.org/10.1136/gutjnl-2014-308114
  13. Ford AC, Bercik P, Morgan DG, Bolino C, Pintos-Sanchez MI, Moayyedi P. The Rome III criteria for the diagnosis of functional dyspepsia in secondary care are not superior to previous definitions. Gastroenterology 2014;146:932-940. https://doi.org/10.1053/j.gastro.2014.01.014
  14. Mahadeva S, Raman MC, Ford AC, et al. Gastro-oesophageal reflux is more prevalent in western dyspeptics: a prospective comparison of British and South-East Asian patients with dyspepsia. Aliment Pharmacol Ther 2005;21:1483-1490. https://doi.org/10.1111/j.1365-2036.2005.02455.x
  15. Suzuki H, Moayyedi P. Helicobacter pylori infection in functional dyspepsia. Nat Rev Gastroenterol Hepatol 2013;10:168-174. https://doi.org/10.1038/nrgastro.2013.9
  16. Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology 2017;153:420-429. https://doi.org/10.1053/j.gastro.2017.04.022
  17. Chow TK, Lambert JR, Wahlqvist ML, Hsu-Hage BH. Helicobacter pylori in Melbourne Chinese immigrants: evidence for oral-oral transmission via chopsticks. J Gastroenterol Hepatol 1995;10:562-569. https://doi.org/10.1111/j.1440-1746.1995.tb01347.x
  18. Gwee KA, Bak YT, Ghoshal UC, et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol 2010;25:1189-1205. https://doi.org/10.1111/j.1440-1746.2010.06353.x
  19. Chang FY, Lu CL, Chen TS. The current prevalence of irritable bowel syndrome in Asia. J Neurogastroenterol Motil 2010;16:389-400. https://doi.org/10.5056/jnm.2010.16.4.389
  20. Ghoshal UC, Abraham P, Bhatia SJ, et al. Comparison of manning, Rome I, II, and III, and asian diagnostic criteria: report of the multicentric Indian irritable bowel syndrome (MIIBS) study. Indian J Gastroenterol 2013;32:369-375. https://doi.org/10.1007/s12664-013-0365-7
  21. Kwan AC, Hu WH, Chan YK, Yeung YW, Lai TS, Yuen H. Prevalence of irritable bowel syndrome in Hong Kong. J Gastroenterol Hepatol 2002;17:1180-1186. https://doi.org/10.1046/j.1440-1746.2002.02871.x
  22. Gwee KA, Wee S, Wong ML, Png DJ. The prevalence, symptom characteristics, and impact of irritable bowel syndrome in an asian urban community. Am J Gastroenterol 2004;99:924-931. https://doi.org/10.1111/j.1572-0241.2004.04161.x
  23. Si JM, Wang LJ, Chen SJ, Sun LM, Dai N. Irritable bowel syndrome consulters in Zhejiang province: the symptoms pattern, predominant bowel habit subgroups and quality of life. World J Gastroenterol 2004;10:1059-1064. https://doi.org/10.3748/wjg.v10.i7.1059
  24. Gwee KA, Lu CL, Ghoshal UC. Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. J Gastroenterol Hepatol 2009;24:1601-1607. https://doi.org/10.1111/j.1440-1746.2009.05984.x
  25. Ghoshal UC, Singh R. Frequency and risk factors of functional gastrointestinal disorders in a rural Indian population. J Gastroenterol Hepatol 2017;32:378-387. https://doi.org/10.1111/jgh.13465
  26. Zhao YF, Ma XQ, Wang R, et al. Epidemiology of functional constipation and comparison with constipation-predominant irritable bowel syndrome: the systematic investigation of gastrointestinal diseases in China (SILC). Aliment Pharmacol Ther 2011;34:1020-1029. https://doi.org/10.1111/j.1365-2036.2011.04809.x
  27. Chen GD, Hu SW, Chen YC, Lin TL, Lin LY. Prevalence and correlations of anal incontinence and constipation in Taiwanese women. Neurourol Urodyn 2003;22:664-669. https://doi.org/10.1002/nau.10067
  28. Lu CL, Chang FY, Chen CY, Luo JC, Lee SD. Significance of Rome II-defined functional constipation in Taiwan and comparison with constipation-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2006;24:429-438. https://doi.org/10.1111/j.1365-2036.2006.02949.x
  29. Jun DW, Park HY, Lee OY, et al. A population-based study on bowel habits in a Korean community: prevalence of functional constipation and self-reported constipation. Dig Dis Sci 2006;51:1471-1477. https://doi.org/10.1007/s10620-006-9087-3
  30. Wong ML, Wee S, Pin CH, Gan GL, Ye HC. Sociodemographic and lifestyle factors associated with constipation in an elderly Asian community. Am J Gastroenterol 1999;94:1283-1291. https://doi.org/10.1111/j.1572-0241.1999.01078.x
  31. Peppas G, Alexiou VG, Mourtzoukou E, Falagas ME. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC gastroenterol 2008;8:5. https://doi.org/10.1186/1471-230X-8-5
  32. Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol 2004;99:750-759. https://doi.org/10.1111/j.1572-0241.2004.04114.x
  33. Cummings JH. Constipation, dietary fibre and the control of large bowel function. Postgrad Med J 1984;60:811-819. https://doi.org/10.1136/pgmj.60.709.811
  34. Tagart RE. The anal canal and rectum: their varying relationship and its effect on anal continence. Dis Colon Rectum 1966;9:449-452. https://doi.org/10.1007/BF02617443
  35. Sikirov D. Comparison of straining during defecation in three positions: results and implications for human health. DigDis Sci 2003;48:1201-1205. https://doi.org/10.1023/A:1024180319005
  36. Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993;38:1569-1580. https://doi.org/10.1007/BF01303162
  37. Moayyedi P, Forman D, Braunholtz D, et al. The proportion of upper gastrointestinal symptoms in the community associated with Helicobacter pylori, lifestyle factors, and nonsteroidal anti-inflammatory drugs. Leeds HELP study group. Am J Gastroenterol 2000;95:1448-1455. https://doi.org/10.1111/j.1572-0241.2000.2126_1.x
  38. Mahadeva S, Yadav H, Rampal S, Everett SM, Goh KL. Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia. Aliment Pharmacol Ther 2010;31:1141-1151.
  39. Mahadeva S, Yadav H, Rampal S, Goh KL. Risk factors associated with dyspepsia in a rural Asian population and its impact on quality of life. Am J Gastroenterol 2010;105:904-912. https://doi.org/10.1038/ajg.2010.26
  40. Pan G, Lu S, Ke M, Han S, Guo H, Fang X. Epidemiologic study of the irritable bowel syndrome in Beijing: stratified randomized study by cluster sampling. Chin Med J 2000;113;35-39.
  41. Kim S, Moon S, Popkin BM. The nutrition transition in South Korea. Am J ClinNutr 2000;71:44-53.
  42. Pilichiewicz AN, Feltrin KL, Horowitz M, et al. Functional dyspepsia is associated with a greater symptomatic response to fat but not carbohydrate, increased fasting and postprandial CCK, and diminished PYY. Am J Gastroenterol 2008;103:2613-2623. https://doi.org/10.1111/j.1572-0241.2008.02041.x
  43. Aro P, Talley NJ, Johansson SE, Agreus L, Ronkainen J. Anxiety is linked to new-onset dyspepsia in the Swedish population: a 10-year follow-up study. Gastroenterology 2015;148:928-937. https://doi.org/10.1053/j.gastro.2015.01.039
  44. Koloski NA, Jones M, Kalantar J, Weltman M, Zaguirre J, Talley NJ. The brain--gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. Gut 2012;61:1284-1290. https://doi.org/10.1136/gutjnl-2011-300474
  45. Miwa H. Life style in persons with functional gastrointestinal disorders--large-scale internet survey of lifestyle in Japan. Neurogastroenterol Motil 2012;24:464-471, e217. https://doi.org/10.1111/j.1365-2982.2011.01872.x
  46. Masud MA, Hasan M, Khan AK. Irritable bowel syndrome in a rural community in Bangladesh: prevalence, symptoms pattern, and health care seeking behavior. Am J Gastroenterol 2001;96:1547-1552. https://doi.org/10.1111/j.1572-0241.2001.03760.x
  47. Perveen I, Hasan M, Masud MA, Bhuiyan MM, Rahman MM. Irritable bowel syndrome in a Bangladeshi urban community: prevalence and health care seeking pattern. Saudi J Gastroenterol 2009;15:239-243. https://doi.org/10.4103/1319-3767.56099
  48. Mahadeva S, Yadav H, Everett SM, Goh KL. Factors influencing dyspepsia-related consultation: differences between a rural and an urban population. Neurogastroenterol Motil 2011;23:846-853. https://doi.org/10.1111/j.1365-2982.2011.01746.x
  49. Ghani SN, Yadav H. Health care in Malaysia. Kuala Lumpur: University of Malaya Press 2008:293.
  50. Lu CL, Chang FY, Lang HC, Chen CY, Luo JC, Lee SD. Gender difference on the symptoms, health-seeking behaviour, social impact and sleep quality in irritable bowel syndrome: a Rome II-based survey in an apparent healthy adult Chinese population in Taiwan. Aliment Pharmacol Ther 2005;21:1497-1505. https://doi.org/10.1111/j.1365-2036.2005.02512.x
  51. Hu WH, Wong WM, Lam CL, et al. Anxiety but not depression determines health care-seeking behaviour in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study. Aliment Pharmacol Ther 2002;16:2081-2088. https://doi.org/10.1046/j.1365-2036.2002.01377.x
  52. Goh KL, Quek KF, Yeo GT, et al. Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy. Aliment Pharmacol Ther 2005;22:859-864. https://doi.org/10.1111/j.1365-2036.2005.02646.x
  53. Goh KL, Cheah PL, Md N, Quek KF, Parasakthi N. Ethnicity and H. pylori as risk factors for gastric cancer in Malaysia: a prospective case control study. Am J Gastroenterol 2007;102:40-45. https://doi.org/10.1111/j.1572-0241.2006.00885.x
  54. Lee YY, Chua AS. What indigestion means to the malays? J Neurogastroenterol Motil 2013;19:295-300. https://doi.org/10.5056/jnm.2013.19.3.295
  55. Abid S, Siddiqui S, Jafri W. Discriminant value of Rome III questionnaire in dyspeptic patients. Saudi J Gastroenterol 2011;17:129-133. https://doi.org/10.4103/1319-3767.77244
  56. Hungin AP, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther 2003;17:643-650. https://doi.org/10.1046/j.1365-2036.2003.01456.x
  57. Ringel Y, Williams RE, Kalilani L, Cook SF. Prevalence, characteristics, and impact of bloating symptoms in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2009;7:68-72. https://doi.org/10.1016/j.cgh.2008.07.008

Cited by

  1. Prevalence of Subthreshold Depression Among Constipation-Predominant Irritable Bowel Syndrome Patients vol.11, pp.None, 2018, https://doi.org/10.3389/fpsyg.2020.01936
  2. Acupuncture of different treatment frequency in postprandial distress syndrome: A pilot randomized clinical trial vol.32, pp.6, 2020, https://doi.org/10.1111/nmo.13812
  3. Gastrointestinal Disorders and Metabolic Syndrome: Dysbiosis as a Key Link and Common Bioactive Dietary Components Useful for their Treatment vol.21, pp.14, 2018, https://doi.org/10.3390/ijms21144929
  4. Management of functional dyspepsia in 2020: a clinical point of view vol.66, pp.4, 2018, https://doi.org/10.23736/s1121-421x.20.02732-4
  5. The association of body mass index with functional dyspepsia is independent of psychological morbidity: A cross-sectional study vol.16, pp.1, 2018, https://doi.org/10.1371/journal.pone.0245511
  6. The epidemiology and quality of life of functional gastrointestinal disorders according to Rome III vs Rome IV criteria: A cross‐sectional study in primary care vol.22, pp.3, 2018, https://doi.org/10.1111/1751-2980.12975
  7. Management of Dyspepsia and Gastroparesis in Patients with Diabetes. A Clinical Point of View in the Year 2021 vol.10, pp.6, 2021, https://doi.org/10.3390/jcm10061313
  8. Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India vol.40, pp.2, 2018, https://doi.org/10.1007/s12664-020-01106-y
  9. Non‐pharmacological intervention in functional dyspepsia: Is this the way forward? vol.36, pp.8, 2018, https://doi.org/10.1111/jgh.15606
  10. Prevalence of irritable bowel syndrome and metabolic syndrome among young adults in an annual health check‐up setting vol.5, pp.10, 2021, https://doi.org/10.1002/jgh3.12639