Veldman, F. orcid.org/0009-0003-3925-3523, Innocenti, F. orcid.org/0000-0001-6113-8992, Aziz, I. orcid.org/0000-0003-4313-0553 et al. (5 more authors) (2026) Prevalence and burden of fatigue across disorders of gut–brain interaction: results from the Rome foundation global epidemiology study. Alimentary Pharmacology & Therapeutics. ISSN: 0269-2813
Abstract
Background Overlap among disorders of gut-brain interaction (DGBI) is common, with many patients experiencing concomitant non-gastrointestinal symptoms. Fatigue is frequently reported, yet population-based prevalence estimates across DGBI are limited.
Aims To examine the prevalence and burden of fatigue among DGBI.
Methods Data were derived from the Rome Foundation Global Epidemiology Study's internet-based survey, conducted in 26 countries using the Rome IV Adult Diagnostic Questionnaire. Fatigue was assessed with single items from the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 and the Patient Health Questionnaire-12 (PHQ-12). Prevalence of fatigue was compared across three groups, including no DGBI, one DGBI and multiple DGBI, with potential associated factors examined using logistic regression.
Results Among 54,127 participants (49% female; mean age 44 years), 59.9% had no DGBI, 26.6% had one DGBI and 13.5% had multiple DGBI. Fatigue prevalence was higher with more DGBI overlap: PROMIS 7.7% (95% CI:7.46–8.04), 16.4% (95% CI: 15.79–17.00), 30.2% (95% CI: 29.16–31.26); PHQ-12 12.6% (95% CI: 12.24–12.96), 25.8% (95% CI: 25.06–26.49), 42.0% (95% CI: 40.83–43.09) for no, one, and multiple DGBI. Fatigue was most common in reflux hypersensitivity (PROMIS 46%, PHQ-12 58%) and irritable bowel syndrome (PROMIS 39%, PHQ-12 53%). Among individuals with DGBI, fatigue was consistently associated across both definitions with female sex, age, BMI, sleep disturbance, higher anxiety and depression scores, greater somatic symptom burden, lower psychological well-being, antidepressant use, and satiety, abdominal pain, and bloating.
Conclusions Fatigue is common and burdensome in DGBI, particularly with overlapping diagnoses. Given the cross-sectional design, directionality between fatigue and DGBI symptom burden remains unclear. Future research should employ longitudinal fatigue assessments to inform targeted management.
Metadata
| Item Type: | Article |
|---|---|
| Authors/Creators: |
|
| Copyright, Publisher and Additional Information: | © 2026 The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial Licence (https://creativecommons.org/licenses/by-nc/4.0/). |
| Keywords: | disorders of gut–brain interaction; epidemiology; fatigue; illness burden |
| Dates: |
|
| Institution: | The University of Sheffield |
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
| Date Deposited: | 01 Jun 2026 11:12 |
| Last Modified: | 01 Jun 2026 11:12 |
| Published Version: | https://doi.org/10.1111/apt.70756 |
| Status: | Published online |
| Publisher: | Wiley |
| Refereed: | Yes |
| Identification Number: | 10.1111/apt.70756 |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:241600 |

CORE (COnnecting REpositories)
CORE (COnnecting REpositories)