Classification of Gastrointestinal Symptom Patterns in Young Adults

Abstract Background: The purpose of this study was to identify common GI symptom groups within a large sample of young adults based on Rome IV functional gastrointestinal (GI) disorder (FGID) symptom domains using the Patient-Reported Outcomes Measurement Information System - GI symptom scales (PROMIS-GI). The PROMIS-GI is a freely available, adaptable, symptom measurement system that is applicable to most health assessment situations. Methods: Participants were 956 adults between the ages of 18 and 25 who completed the PROMIS-GI as part of ongoing research monitoring physical and psychological health of students at a major southeastern university. GI symptom groups were determined using a latent class analysis (LCA) approach. Homogenous groups of participants (latent classes) were then compared on key psychosocial factors including self-reported mood, anxiety, physical health related quality of life (HRQoL), and diet using MANOVA. Results: Three groups were identified based on GI symptom elevations: Normal (n=649), Mild (n=257), and Moderate (n=50). Self-reported mood and anxiety levels were significantly higher in the mild and moderate GI symptom groups, and physical health HRQoL was significantly lower. Conclusions: This study demonstrated that approximately a third of young adults surveyed were experiencing at least one GI symptom above normative levels. Both the mild and moderate GI groups demonstrated a similar configuration of symptoms with the highest relative elevations in pain, gas/bloating, and nausea/vomiting. Following the Rome IV diagnostic criteria, the configuration of symptoms for the mild and moderate groups were consistent with IBS mixed or unclassified subtypes. Self-reported anxiety and depression increased, and physical functioning decreased with the severity of GI symptoms. Mild to moderate GI symptoms appear to emerge at much earlier ages and are more frequent than previously documented. Based on this study’s findings, it is recommended that health service providers evaluate 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 complaints.