{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:31:49Z","timestamp":1776893509113,"version":"3.51.2"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is no term for bloating in Spanish and distension is a very technical word. \u201cInflammation\u201d\/\u201cswelling\u201d 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\u2010IBS patients. However, their effectiveness in the general population and in subjects with Rome IV\u2010DGBI is unknown. We analyzed the use of pictograms for assessing bloating\/distension in the general population in Mexico.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Rome Foundation Global Epidemiology Study (RFGES) in Mexico (<jats:italic>n<\/jats:italic>\u2009=\u20092001) included questions about the presence of VDs \u201cinflammation\u201d\/\u201cswelling\u201d 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>\u201cInflammation\u201d\/\u201cswelling\u201d was reported by 51.5% and distension by 23.8% of the entire study population; while 1.2% and 25.3% did not comprehend \u201cInflammation\u201d\/\u201cswelling\u201d or distension, respectively. Subjects without (31.8%) or not comprehending \u201cinflammation\u201d\/\u201cswelling\u201d\/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\u201344.9) vs. without: 14.5% (12.0\u201317.0); and in subjects with distension by VDs: 29.4% (25.4\u201333.3) vs. without: 17.2% (14.9\u201319.5). 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%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Pictograms 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14577","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T15:30:31Z","timestamp":1680535831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pictograms to assess bloating and distension symptoms in the general population in Mexico: Results of The Rome Foundation Global Epidemiology Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8440-8542","authenticated-orcid":false,"given":"Max J.","family":"Schmulson","sequence":"first","affiliation":[{"name":"Laboratory of Liver, Pancreas and Motility (HIPAM), Unit of Research in Experimental Medicine, Faculty of Medicine Universidad Nacional Aut\u00f3noma de M\u00e9xico (UNAM) Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelio","family":"L\u00f3pez\u2010Colombo","sequence":"additional","affiliation":[{"name":"UMAE\u2010Hospital de Especialidades, Centro M\u00e9dico Nacional Manuel Avila Camacho Puebla Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Montiel\u00a0Jarquin","sequence":"additional","affiliation":[{"name":"Education and Research Directorate, Centro M\u00e9dico Nacional Manuel Avila Camacho Instituto Mexicano del Seguro Social Puebla Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7058-2574","authenticated-orcid":false,"given":"Gerardo A.","family":"Puentes\u2010Leal","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology Centro Hospitalario Serena del Mar Cartagena de Indias Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olafur S.","family":"Palsson","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrikant I.","family":"Bangdiwala","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods Evidence and Impact McMaster University Ontario Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-3689","authenticated-orcid":false,"given":"Ami D.","family":"Sperber","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(15)32242-3"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14364"},{"key":"e_1_2_9_5_1","first-page":"756","article-title":"Prevalence and associated factors of bloating and distension symptoms in the general population: findings of a survey in three countries","volume":"57","author":"Palsson OSTJ","year":"2022","journal-title":"Gastroenterology"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16214"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.031"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.011"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14330"},{"issue":"1","key":"e_1_2_9_11_1","article-title":"Face\u2010to\u2010face interviews versus Internet survey: comparison of the two data collection methods used in the Rome Foundation Global Epidemiology Study, and implications for population\u2010based survey research","author":"Sperber AD","year":"2023","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","DOI":"10.1111\/nmo.14431","article-title":"The Rome Foundation Global Epidemiology study: research opportunities national and worldwide","volume":"34","author":"Tack J","year":"2022","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.05336.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04143.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.05.042"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.142810"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14229"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"BashashatiM SchmulsonMJ SarosiekI et al.Disorders of gut\u2010brain interaction in the US\u2010Mexico border: A survey using Rome IV criteria. 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