Pictograms to assess bloating and distension symptoms in the general population in Mexico: Results of The Rome Foundation Global Epidemiology Study

Abstract

AbstractBackgroundThere is no term for bloating in Spanish and distension is a very technical word. “Inflammation”/“swelling” are the most frequently used expressions for bloating/distension in Mexico, and pictograms are more effective than verbal descriptors (VDs) for bloating/distension in general GI and Rome III‐IBS patients. However, their effectiveness in the general population and in subjects with Rome IV‐DGBI is unknown. We analyzed the use of pictograms for assessing bloating/distension in the general population in Mexico.MethodsThe Rome Foundation Global Epidemiology Study (RFGES) in Mexico (n = 2001) included questions about the presence of VDs “inflammation”/“swelling” and abdominal distension, their comprehension, and pictograms (normal, bloating, distension, both). We compared the pictograms with the Rome IV question about the frequency of experiencing bloating/distension, and with the VDs.Key Results“Inflammation”/“swelling” was reported by 51.5% and distension by 23.8% of the entire study population; while 1.2% and 25.3% did not comprehend “Inflammation”/“swelling” or distension, respectively. Subjects without (31.8%) or not comprehending “inflammation”/“swelling”/distension (68.4%) reported bloating/distension by pictograms. Bloating and/or distension by the pictograms were much more frequent in those with DGBI: 38.3% (95%CI: 31.7–44.9) vs. without: 14.5% (12.0–17.0); and in subjects with distension by VDs: 29.4% (25.4–33.3) vs. without: 17.2% (14.9–19.5). Among subjects with bowel disorders, those with IBS reported bloating/distension by pictograms the most (93.8%) and those with functional diarrhea the least (71.4%).Conclusions & InferencesPictograms are more effective than VDs for assessing the presence of bloating/distension in Spanish Mexico. Therefore, they should be used to study these symptoms in epidemiological research.