A Journey Mapping Study on the Full-Course Management of Elderly Patients Undergoing Radical Esophagectomy for Esophageal Cancer.

The disorders of gut–brain interaction (DGBI) are defined by a range of gastrointestinal symptoms caused by any combination of motility disturbance, visceral hypersensitivity, modified mucosal and immunological function, altered gut microbiota, altered central nervous system processing and genetic polymorphism. [] Irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), and functional diarrhea (FDr) are the most common conditions that fall within the DGBI spectrum. [] These disorders affect up to 30–40% of the general population in Western countries, and their prevalence decreases with age. [, ] Although the burden of individual DGBI in Italy such as IBS [] or FD [] has been quantified previously, no study to date has provided a thorough, country‐specific assessment of the burden of DGBI. The Rome Foundation Global Epidemiology Study (RFGES) evaluating a total of 22 DGBI revealed that 40.3% out of the 54,127 participants in 26 countries, including Italy, met diagnostic criteria for at least one DGBI, suggesting that these diseases represent a major global burden of these disorders []. The RFGES study in Italy included 2063 respondents, of whom about 40% fulfilled the criteria for at least one DGBI. [] In the context of European countries, Italy, and other southern European countries around the Mediterranean Sea are renowned throughout the world for their Mediterranean lifestyle, which has been associated with general well-being and reduced rates of psychological disorders, even though the latter were previously associated with higher prevalence rates of DGBI. [] Within southern European countries, however, there are regional differences in the extent of adherence to the Mediterranean diet, lifestyle, and overall psychosocial well-being. [] Within this study, we aimed first to report the burden of DGBI in Italy, stratified by regions, age, gender, and living area. Then, we aimed to identify differences in the burden of DGBI between Italy and the rest of Europe. Finally, we compared DGBI risk factors among Italian and other European populations, focusing on the most reported DGBI, including FD, IBS, FC, and FDr. This study was based on data from the RFGES, a large multi-national cross-sectional survey aimed at assessing the prevalence and burden of DGBI. The methodology of the RFGES has been published previously and described in detail elsewhere. [] In brief, this study collected data from 54,127 adult participants (≥ 18 years) across 26 countries via either internet-based or face-to-face interviews. For the current analysis, only data obtained through internet-based self-administered questionnaires were used. Participants were drawn from a pre-existing online panel of individuals who had consented to participate in health-related research. To minimize selection bias, the survey was introduced as a general health study without any mention of gastrointestinal or psychological symptoms. All participants provided electronic informed consent prior to participation, and data were collected anonymously. The study received ethics approval or was deemed exempt in each participating country, including Italy.