ArticleGastroenterology2021
Epidemiologic Burden and Treatment of Chronic Symptomatic Functional Bowel Disorders in the United States: A Nationwide Analysis.
Article in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- The Safety of Pharmacotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.The American journal of gastroenterology · 2026Pooled it
- Meta-analysis of gut microbiota alterations in patients with irritable bowel syndrome.Frontiers in microbiology · 2024Pooled it
- The effectiveness of Zhi-Shi plaster acupoint therapy combined with lactulose in the treatment of geriatrics functional constipation: a randomized controlled trial.Frontiers in neurology · 2025Trial
- Impact of resistant starch type 3 on fecal microbiota and stool frequency in Thai adults with chronic constipation randomized clinical trial.Scientific reports · 2024Trial
- A Global Scoping Review of Clinicians' Perceptions of Anorectal Biofeedback Compared with Novel Australian Data.Journal of clinical medicine · 2026Review
- Proteases and Abdominal Pain-Old Dog, New (Microbial) Tricks.Cellular and molecular gastroenterology and hepatology · 2026Review
- Piezo knockdown reduces 5‑hydroxytryptamine release from enterochromaffin cells and exacerbates intestinal dyskinesia in mice with functional constipation.International journal of molecular medicine · 2025Article
- Association between daily calcium intake and the prevalence of chronic diarrhea: an analysis of NHANES 2005-2010 data.BMC gastroenterology · 2025Article
- A focus group study to assess perspectives of patients with irritable bowel syndrome on human milk oligosaccharides and lifestyle insights.European journal of nutrition · 2025Article
- Global, regional, and national burden of disease analysis on paralytic ileus and intestinal obstruction in adults aged 65 and over from 1990 to 2021, with projections for 2030: a Global Burden of Disease Study 2021 analysis.BMC gastroenterology · 2025Article
- Association between Life's Crucial 9 and bowel health among US adults: a cross-sectional analysis of NHANES 2005-2010 with external validation.Frontiers in medicine · 2025Article
- AnGut microbiome (Cambridge, England) · 2025Article
- Independent role of two novel abdominal fat indicators in chronic diarrhoea.Frontiers in medicine · 2025Article
- Passive Smoking Is Associated with the Risk of Functional Bowel Disorders Among College Freshmen.Healthcare (Basel, Switzerland) · 2024Article
- Chronic Visceral Pain: New Peripheral Mechanistic Insights and Resulting Treatments.Gastroenterology · 2024Review
- Upregulation of KDM6B in the anterior cingulate cortex contributes to neonatal maternal deprivation-induced chronic visceral pain in mice.Molecular pain · 2024Article
- Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation.World journal of clinical cases · 2024Article
- Updates and Challenges in ENS Cell Therapy for the Treatment of Neurointestinal Diseases.Biomolecules · 2024Review
- Association of Functional Gastrointestinal Disorders with Adolescent Idiopathic Scoliosis.Children (Basel, Switzerland) · 2024Article
- Clinical outcomes associated with antidepressant use in inflammatory bowel disease patients and a matched control cohort.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsFunctional bowel disorders (FBDs) are the most common gastrointestinal problems managed by physicians. We aimed to assess the burden of chronic symptomatic FBDs on ambulatory care delivery in the United States and evaluate patterns of treatment.
methodsData from the National Ambulatory Medical Care Survey were used to estimate annual rates and associated costs of ambulatory visits for symptomatic irritable bowel syndrome, chronic functional abdominal pain, constipation, or diarrhea. The weighted proportion of visits associated with pharmacologic and nonpharmacologic (stress/mental health, exercise, diet counseling) interventions were calculated, and predictors of treatment strategy were evaluated in multivariable multinomial logistic regression.
resultsFrom 2007-2015, approximately 36.9 million (95% CI, 31.4-42.4) weighted visits in patients of non-federally employed physicians for chronic symptomatic FBDs were sampled. There was an annual weighted average of 2.7 million (95% CI, 2.3-3.2) visits for symptomatic irritable bowel syndrome/chronic abdominal pain, 1.0 million (95% CI, 0.8-1.2) visits for chronic constipation, and 0.7 million (95% CI, 0.5-0.8) visits for chronic diarrhea. Pharmacologic therapies were prescribed in 49.7% (95% CI, 44.7-54.8) of visits compared to nonpharmacologic interventions in 19.8% (95% CI, 16.0-24.2) of visits (P < .001). Combination treatment strategies were more likely to be implemented by primary care physicians and in patients with depression or obesity. The direct annual cost of ambulatory clinic visits alone for chronic symptomatic FBDs is approximately US$358 million (95% CI, 233-482 million).
conclusionsThe management of chronic symptomatic FBDs is associated with considerable health care resource use and cost. There may be an opportunity to improve comprehensive FBD management because fewer than 1 in 5 ambulatory visits include nonpharmacologic treatment strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.