{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T08:44:55Z","timestamp":1791794695072,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Food\u2010related gastrointestinal (GI) symptoms are highly prevalent in patients with IBS. Although dietary components may trigger symptoms through luminal mechanisms, cognitive expectations may also shape symptom perception within the gut\u2010brain axis. No validated instrument exists to measure food\u2010related symptom expectations. We developed and validated the Food Expectation Questionnaire (FEX\u2010Q).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The FEX\u2010Q was developed using a stepwise process including patient input, face\u2010to\u2010face validation, and an online validation. The finalized questionnaire presents food images rated on six visual analogue scale items, with food\u2010related GI symptom expectation as the core measure, alongside taste preference, willingness to eat, perceived healthiness, and perceived fat and carbohydrate content. Adults with IBS and non\u2010IBS controls completed the FEX\u2010Q together with validated questionnaires assessing GI symptoms, psychological distress, food\u2010related quality of life, and food avoidance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Face\u2010to\u2010face validation supported food recognition, item comprehension, and response processes, resulting in the final 44\u2010image version. In the online survey including 134 patients with IBS and 126 non\u2010IBS controls, the FEX\u2010Q demonstrated known\u2010groups validity with higher symptom expectation scores in IBS than in non\u2010IBS controls (50.1 vs. 18.4). Validity of the nutrient\u2010perception items was supported by correlations between perceived and calculated fat (\n r<\/jats:italic>\n \u2009=\u20090.78) and carbohydrate content (\n r<\/jats:italic>\n \u2009=\u20090.59). Convergent validity was demonstrated through significant associations with GI symptom severity (\n r<\/jats:italic>\n \u2009=\u20090.42) and food\u2010related quality of life (\n r<\/jats:italic>\n \u2009=\u2009\u22120.39). Split\u2010half reliability was high (\n r<\/jats:italic>\n \u2009=\u20090.88).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The FEX\u2010Q is a promising instrument for assessing food\u2010related symptom expectations and perceptions. It may facilitate future mechanistic research into food\u2010related symptom generation and inform personalized dietary management in IBS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nmo.70464","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:50:26Z","timestamp":1791791426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of the Food Expectation Questionnaire (\n FEX<\/scp>\n \u2010Q): An Image\u2010Based Instrument to Assess Food\u2010Related Perceptions and Symptom Expectations"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9602-3391","authenticated-orcid":false,"given":"Ryo","family":"Katsumata","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-846X","authenticated-orcid":false,"given":"Stine","family":"St\u00f6rsrud","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg Gothenburg Sweden"},{"name":"Department of Medicine Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-1313","authenticated-orcid":false,"given":"Magnus","family":"Simr\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg Gothenburg Sweden"},{"name":"Department of Medicine Sahlgrenska University Hospital Gothenburg Sweden"},{"name":"Center for Functional GI and Motility Disorders University of North Carolina\/Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-1929","authenticated-orcid":false,"given":"Sanna","family":"Nybacka","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg Gothenburg Sweden"},{"name":"Department of Medicine Sahlgrenska University Hospital Gothenburg Sweden"},{"name":"Department of Life Sciences Chalmers University of Technology Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/ajg.2013.105","article-title":"Self\u2010Reported Food\u2010Related Gastrointestinal Symptoms in IBS Are Common and Associated With More Severe Symptoms and Reduced Quality of Life","volume":"108","author":"B\u00f6hn L.","year":"2013","journal-title":"American Journal of Gastroenterology"},{"issue":"6","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1053\/j.gastro.2026.01.041","article-title":"Development of the Rome V Diagnostic Questionnaires","volume":"170","author":"Palsson O. 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K.","year":"2010","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"2","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.4103\/AMH.AMH_25_18","article-title":"A Review of Functional Gastrointestinal Disorders: A Primer for Mental Health Professionals","volume":"19","author":"Chandran S.","year":"2018","journal-title":"Archives of Mental Health"},{"issue":"12","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1007\/s00535-023-02031-5","article-title":"Brain Activity in Response to Food Images in Patients With Irritable Bowel Syndrome and Functional Dyspepsia","volume":"58","author":"Katsumata R.","year":"2023","journal-title":"Journal of Gastroenterology"},{"issue":"6","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1053\/j.gastro.2026.02.009","article-title":"Biopsychosocial Aspects of Adult and Pediatric Disorders of Gut\u2010Brain Interaction","volume":"170","author":"Elsenbruch S.","year":"2026","journal-title":"Gastroenterology"},{"issue":"6","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1053\/j.gastro.2021.12.248","article-title":"AGA Clinical Practice Update on the Role of Diet in Irritable Bowel Syndrome: Expert Review","volume":"162","author":"Chey W. 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A.","year":"2016","journal-title":"Journal of Human Nutrition and Dietetics"},{"issue":"6","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1002\/ueg2.12265","article-title":"Irritable Bowel Syndrome With Food\u2010Related Symptoms: Future Directions in the Clinical Management","volume":"10","author":"Melchior C.","year":"2022","journal-title":"United European Gastroenterology Journal"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample Sizes for Saturation in Qualitative Research: A Systematic Review of Empirical Tests","volume":"292","author":"Hennink M.","year":"2022","journal-title":"Social Science & Medicine"},{"issue":"1","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/1525822X05279903","article-title":"How Many Interviews Are Enough?: An Experiment With Data Saturation and Variability","volume":"18","author":"Guest G.","year":"2006","journal-title":"Field Methods"},{"issue":"4","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/1049732316665344","article-title":"Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough?","volume":"27","author":"Hennink M. 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