Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population

J Gastroenterol Hepatol. 2017 Feb;32(2):378-387. doi: 10.1111/jgh.13465.


Background and aim: As best estimates on functional gastrointestinal disorders (FGIDs) prevalence are expected from community studies, which are scanty from Asia, we evaluated the prevalence and risk factors of FGIDs in a rural Indian community.

Methods: House-to-house survey was undertaken by trained interviewers using translated-validated Rome III and hospital anxiety and depression questionnaires.

Result: Among 3426 subjects ≥ 18 years old from 3 villages in Uttar Pradesh, 84% participated, of whom 80% were finally analyzed. Of these 2774 subjects (age 38.4 ± 16.5 years, 1573 [56.7%] male), 2654 [95.7%] were vegetarian and 120 [4.3%] non-vegetarian. Socioeconomic classes were upper (16.7%), upper middle (15.1%), lower middle (22%), upper lower (22.2%), and lower (24%) using Prasad's Classification; 603 (21.7%) had FGIDs (413 [14.9%] dyspepsia, 75 [2.7%] irritable bowel syndrome (IBS) and 115 [4.1%] dyspepsia-IBS overlap), by Rome III criteria. In subjects with dyspepsia, 49/528 (9%) had epigastric pain, 141 (27%) postprandial distress syndromes (EPS, PDS) and 338 (64%) EPS-PDS overlap. IBS was more often diarrhea than constipation-predominant subtype. On univariate analysis, chewing tobacco, aerated drink, tea/coffee, disturbed sleep, vegetarianism, and anxiety parameters and presence of dyspepsia predicting occurrence of IBS were associated with FGIDs. On multivariate analysis, chewing tobacco, aerated soft drink, tea/coffee, vegetarianism, anxiety parameters, and presence of dyspepsia predicting IBS were significant.

Conclusion: Functional gastrointestinal disorders, particularly dyspepsia-IBS overlap, are common in rural Indian population; the risk factors included chewing tobacco, aerated soft drink, tea/coffee, vegetarian diet, disturbed sleep, anxiety, and dyspepsia predicting occurrence of IBS.

Keywords: Irritable bowel syndrome; constipation; diarrhea; epidemiology; functional GI diseases; functional dyspepsia.

MeSH terms

  • Adolescent
  • Adult
  • Carbonated Beverages / adverse effects
  • Coffee / adverse effects
  • Diet, Vegan / adverse effects
  • Dyspepsia / etiology
  • Female
  • Gastrointestinal Diseases / epidemiology*
  • Gastrointestinal Diseases / etiology*
  • Humans
  • India / epidemiology
  • Irritable Bowel Syndrome / etiology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Rural Population / statistics & numerical data*
  • Surveys and Questionnaires
  • Tea / adverse effects
  • Tobacco Use / adverse effects
  • Young Adult


  • Coffee
  • Tea