Comparative Study on Burden, Features and Determinants of Disorders of Gut-Brain Interaction Between Southern Europe and the Rest of Continent: Results From the Rome Foundation Global Epidemiology Study

Background and Aim: Disorders of gut–brain interaction (DGBI) are highly prevalent worldwide. Although the epidemiology of DGBIs in Europe has been previously investigated, data comparing disease prevalence across European regions in relation to sociodemographic and lifestyle factors are lacking. Therefore, this study aimed to assess the prevalence, regional distribution, and associated factors of DGBI in Southern Europe, and to compare findings with other European regions. Methods: Data were drawn from the Rome Foundation Global Epidemiology Study (RFGES). A representative sample of 20,420 European adults completed a comprehensive internet-based questionnaire assessing DGBI presence, psychological distress, somatic symptoms, dietary habits, and healthcare utilization. Comparative analyses were conducted between Southern European countries and the rest of the continent (Northern, Western, and Eastern European countries). Multivariate logistic regression identified independent associated factors. Results: The prevalence of adults with at least one DGBI was significantly higher in Southern Europe than in the rest of Europe (44.0% [42.4–45.5] vs. 39.0% [38.3–39.8]; p < 0.001). Irritable bowel syndrome and functional dyspepsia were more prevalent in Southern Europe than in the rest of Europe. Similar trends were found for functional constipation and functional diarrhea. Individuals with DGBI in Southern Europe showed higher psychological distress but lower somatic symptom burden and lower work productivity and activity impairment. In multivariable models, residence in Southern Europe, female sex, younger age, higher psychological distress, greater somatic symptom burden, higher educational attainment, urban residence and more frequent healthcare utilization were independently associated with DGBI. Conclusions: Southern European populations exhibit a higher prevalence of DGBI compared with other European regions. Individuals with DGBI in Southern Europe showed higher rates of psychological distress, whereas those in the rest of Europe showed higher somatic symptom burden, greater work productivity and activity impairment. DGBI rates in Europe appear to be driven by a multifactorial interplay of demographic and psychosocial factors.