Global patterns of prescription pain medication usage in disorders of gut–brain interactions

Abstract

Background: Forty percent of individuals globally meet Rome IV criteria for a disorder of gut– brain interaction (DGBI). The global burden of pain across these disorders has not been characterized.Methods: Our study included 54,127 respondents from the 26 Internet survey coun-tries. Prescription pain medication usage was selected as the proxy for pain. The associations between prescription pain medications and the environmental, sociode-mographic, psychosocial, and DGBI diagnosis variables were investigated using the multivariate generalized robust Poisson regression model.Key Results: Respondents with DGBI used prescription pain medications at higher rates than those without a DGBI diagnosis with pooled prevalence rate of 14.8% (95% confidence interval [CI], 14.4– 15.3%), varying by country from 6.8% to 25.7%. The pooled prevalence ratio of prescription pain medication usage in respondents with and without DGBI was 2.2 (95% CI: 2.1– 2.4). Factors associated with higher preva -lence of pain medication usage among respondents with a DGBI diagnosis included living in a small community, increased anxiety, depression or somatization, increased stress concern or embarrassment about bowel functioning and having more than one anatomic DGBI diagnosis.Conclusion: 14.8% of patients globally with at least one diagnosis of DGBI were on prescription pain medications with wide geographic variation, about twice as many as their counterparts without a diagnosis of DGBI. Environmental, sociodemographic, and individual factors may influence clinicians to consider personalized, multimodal approaches to address pain in patients with DGBI.