Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors: a nationwide cross-sectional study

Anne Karmisholt Grosen; Jens Kjærgaard Boldsen; Susan Mikkelsen; Simon Mark Dahl Baunwall; Jens Frederik Dahlerup; Khoa Manh Dinh; Mie Topholm Bruun; Bitten Aagaard; Christina Mikkelsen; Janna Nissen; Thorsten Brodersen; Mikkel Steen Petersen; Klaus Rostgaard; Henrik Hjalgrim; Erik Sørensen; Sisse Rye Ostrowski; Ole Birger Pedersen; Christian Lodberg Hvas; Christian Erikstrup

doi:10.1136/bmjgast-2024-001518

Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors: a nationwide cross-sectional study

Anne Karmisholt Grosen^*, Jens Kjærgaard Boldsen, Susan Mikkelsen, Simon Mark Dahl Baunwall, Jens Frederik Dahlerup, Khoa Manh Dinh, Mie Topholm Bruun, Bitten Aagaard, Christina Mikkelsen, Janna Nissen, Thorsten Brodersen, Mikkel Steen Petersen, Klaus Rostgaard, Henrik Hjalgrim, Erik Sørensen, Sisse Rye Ostrowski, Ole Birger Pedersen, Christian Lodberg Hvas, Christian Erikstrup

^*Corresponding author for this work

2 Citations (Scopus)

Abstract

OBJECTIVE: To characterise gastrointestinal symptoms and bowel habits in healthy blood donors and explore symptom phenotypes and their associated factors.

METHODS: Between November 2020 and March 2023, 53 046 participants in the nationwide Danish Blood Donor Study completed a questionnaire including 13 gastrointestinal symptoms, defaecation pattern regularity, stool frequency, and stool consistency. We used a data-driven approach to explore symptom phenotypes and investigated associated factors by multinomial logistic regression.

RESULTS: Among the 53 046 participants (52% women), 68% (95% CI 67.5% to 68.3%) reported at least one of 13 gastrointestinal symptoms. The most frequent symptoms were bloating (40%), abdominal rumbling (40%), abdominal pain (17%), acid regurgitation (13%), heartburn (12%), diarrhoea (12%), nausea (12%), and constipation (10%). Half of the participants (50%) had a regular defaecation pattern (defined as generally the same stool consistency and stool frequency) consisting of Bristol Stool Form Scale 4 stools 1-3 times per day. Symptom phenotypes and their prevalence among 51 820 near-complete case participants were as follows: (1) no gastrointestinal symptoms (32%); (2) bloating and/or rumbling only (21%); (3) acid regurgitation and/or heartburn only (4%); (4) any other one or two symptoms (14%); (5) any three or four symptoms (18%); (6) any five or six symptoms (7%); (7) at least seven symptoms (3%). The acid regurgitation and/or heartburn only phenotype associated with obesity, and the remaining symptomatic phenotypes were associated with female sex, decreasing age, and an irregular defaecation pattern, even after excluding individuals with self-reported irritable bowel syndrome, lactose intolerance, or gluten intolerance.

CONCLUSION: Most healthy adults, especially women younger than 50 years, experience gastrointestinal symptoms. Symptom phenotypes strongly correlate with sex, age, and bowel habits.

Original language	English
Article number	e001518
Journal	BMJ Open Gastroenterology
Volume	12
Issue number	1
ISSN	2054-4774
DOIs	https://doi.org/10.1136/bmjgast-2024-001518
Publication status	Published - 8 Feb 2025

Keywords

Humans
Female
Male
Denmark/epidemiology
Cross-Sectional Studies
Adult
Blood Donors/statistics & numerical data
Middle Aged
Gastrointestinal Diseases/epidemiology
Prevalence
Defecation/physiology
Surveys and Questionnaires
Young Adult
Constipation/epidemiology
Abdominal Pain/epidemiology
Heartburn/epidemiology
Phenotype
Adolescent
Aged
IRRITABLE BOWEL SYNDROME
FUNCTIONAL BOWEL DISORDER
GASTROINTESTINAL FUNCTION
EPIDEMIOLOGY

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Grosen, A. K., Boldsen, J. K., Mikkelsen, S., Mark Dahl Baunwall, S., Dahlerup, J. F., Dinh, K. M., Topholm Bruun, M., Aagaard, B., Mikkelsen, C., Nissen, J., Brodersen, T., Petersen, M. S., Rostgaard, K., Hjalgrim, H., Sørensen, E., Ostrowski, S. R., Pedersen, O. B., Hvas, C. L., & Erikstrup, C. (2025). Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors: a nationwide cross-sectional study. BMJ Open Gastroenterology, 12(1), Article e001518. https://doi.org/10.1136/bmjgast-2024-001518

Grosen, AK, Boldsen, JK, Mikkelsen, S, Mark Dahl Baunwall, S, Dahlerup, JF, Dinh, KM, Topholm Bruun, M, Aagaard, B, Mikkelsen, C , Nissen, J, Brodersen, T, Petersen, MS, Rostgaard, K, Hjalgrim, H , Sørensen, E , Ostrowski, SR, Pedersen, OB, Hvas, CL & Erikstrup, C 2025, 'Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors: a nationwide cross-sectional study', BMJ Open Gastroenterology, vol. 12, no. 1, e001518. https://doi.org/10.1136/bmjgast-2024-001518

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title = "Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors: a nationwide cross-sectional study",

abstract = "OBJECTIVE: To characterise gastrointestinal symptoms and bowel habits in healthy blood donors and explore symptom phenotypes and their associated factors.METHODS: Between November 2020 and March 2023, 53 046 participants in the nationwide Danish Blood Donor Study completed a questionnaire including 13 gastrointestinal symptoms, defaecation pattern regularity, stool frequency, and stool consistency. We used a data-driven approach to explore symptom phenotypes and investigated associated factors by multinomial logistic regression.RESULTS: Among the 53 046 participants (52\% women), 68\% (95\% CI 67.5\% to 68.3\%) reported at least one of 13 gastrointestinal symptoms. The most frequent symptoms were bloating (40\%), abdominal rumbling (40\%), abdominal pain (17\%), acid regurgitation (13\%), heartburn (12\%), diarrhoea (12\%), nausea (12\%), and constipation (10\%). Half of the participants (50\%) had a regular defaecation pattern (defined as generally the same stool consistency and stool frequency) consisting of Bristol Stool Form Scale 4 stools 1-3 times per day. Symptom phenotypes and their prevalence among 51 820 near-complete case participants were as follows: (1) no gastrointestinal symptoms (32\%); (2) bloating and/or rumbling only (21\%); (3) acid regurgitation and/or heartburn only (4\%); (4) any other one or two symptoms (14\%); (5) any three or four symptoms (18\%); (6) any five or six symptoms (7\%); (7) at least seven symptoms (3\%). The acid regurgitation and/or heartburn only phenotype associated with obesity, and the remaining symptomatic phenotypes were associated with female sex, decreasing age, and an irregular defaecation pattern, even after excluding individuals with self-reported irritable bowel syndrome, lactose intolerance, or gluten intolerance.CONCLUSION: Most healthy adults, especially women younger than 50 years, experience gastrointestinal symptoms. Symptom phenotypes strongly correlate with sex, age, and bowel habits.",

keywords = "Humans, Female, Male, Denmark/epidemiology, Cross-Sectional Studies, Adult, Blood Donors/statistics \& numerical data, Middle Aged, Gastrointestinal Diseases/epidemiology, Prevalence, Defecation/physiology, Surveys and Questionnaires, Young Adult, Constipation/epidemiology, Abdominal Pain/epidemiology, Heartburn/epidemiology, Phenotype, Adolescent, Aged, IRRITABLE BOWEL SYNDROME, FUNCTIONAL BOWEL DISORDER, GASTROINTESTINAL FUNCTION, EPIDEMIOLOGY",

author = "Grosen, \{Anne Karmisholt\} and Boldsen, \{Jens Kj{\ae}rgaard\} and Susan Mikkelsen and \{Mark Dahl Baunwall\}, Simon and Dahlerup, \{Jens Frederik\} and Dinh, \{Khoa Manh\} and \{Topholm Bruun\}, Mie and Bitten Aagaard and Christina Mikkelsen and Janna Nissen and Thorsten Brodersen and Petersen, \{Mikkel Steen\} and Klaus Rostgaard and Henrik Hjalgrim and Erik S{\o}rensen and Ostrowski, \{Sisse Rye\} and Pedersen, \{Ole Birger\} and Hvas, \{Christian Lodberg\} and Christian Erikstrup",

note = "{\textcopyright} Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.",

year = "2025",

month = feb,

day = "8",

doi = "10.1136/bmjgast-2024-001518",

language = "English",

volume = "12",

journal = "BMJ Open Gastroenterology",

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TY - JOUR

T1 - Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors

T2 - a nationwide cross-sectional study

AU - Grosen, Anne Karmisholt

AU - Boldsen, Jens Kjærgaard

AU - Mikkelsen, Susan

AU - Mark Dahl Baunwall, Simon

AU - Dahlerup, Jens Frederik

AU - Dinh, Khoa Manh

AU - Topholm Bruun, Mie

AU - Aagaard, Bitten

AU - Mikkelsen, Christina

AU - Nissen, Janna

AU - Brodersen, Thorsten

AU - Petersen, Mikkel Steen

AU - Rostgaard, Klaus

AU - Hjalgrim, Henrik

AU - Sørensen, Erik

AU - Ostrowski, Sisse Rye

AU - Pedersen, Ole Birger

AU - Hvas, Christian Lodberg

AU - Erikstrup, Christian

N1 - © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

PY - 2025/2/8

Y1 - 2025/2/8

N2 - OBJECTIVE: To characterise gastrointestinal symptoms and bowel habits in healthy blood donors and explore symptom phenotypes and their associated factors.METHODS: Between November 2020 and March 2023, 53 046 participants in the nationwide Danish Blood Donor Study completed a questionnaire including 13 gastrointestinal symptoms, defaecation pattern regularity, stool frequency, and stool consistency. We used a data-driven approach to explore symptom phenotypes and investigated associated factors by multinomial logistic regression.RESULTS: Among the 53 046 participants (52% women), 68% (95% CI 67.5% to 68.3%) reported at least one of 13 gastrointestinal symptoms. The most frequent symptoms were bloating (40%), abdominal rumbling (40%), abdominal pain (17%), acid regurgitation (13%), heartburn (12%), diarrhoea (12%), nausea (12%), and constipation (10%). Half of the participants (50%) had a regular defaecation pattern (defined as generally the same stool consistency and stool frequency) consisting of Bristol Stool Form Scale 4 stools 1-3 times per day. Symptom phenotypes and their prevalence among 51 820 near-complete case participants were as follows: (1) no gastrointestinal symptoms (32%); (2) bloating and/or rumbling only (21%); (3) acid regurgitation and/or heartburn only (4%); (4) any other one or two symptoms (14%); (5) any three or four symptoms (18%); (6) any five or six symptoms (7%); (7) at least seven symptoms (3%). The acid regurgitation and/or heartburn only phenotype associated with obesity, and the remaining symptomatic phenotypes were associated with female sex, decreasing age, and an irregular defaecation pattern, even after excluding individuals with self-reported irritable bowel syndrome, lactose intolerance, or gluten intolerance.CONCLUSION: Most healthy adults, especially women younger than 50 years, experience gastrointestinal symptoms. Symptom phenotypes strongly correlate with sex, age, and bowel habits.

AB - OBJECTIVE: To characterise gastrointestinal symptoms and bowel habits in healthy blood donors and explore symptom phenotypes and their associated factors.METHODS: Between November 2020 and March 2023, 53 046 participants in the nationwide Danish Blood Donor Study completed a questionnaire including 13 gastrointestinal symptoms, defaecation pattern regularity, stool frequency, and stool consistency. We used a data-driven approach to explore symptom phenotypes and investigated associated factors by multinomial logistic regression.RESULTS: Among the 53 046 participants (52% women), 68% (95% CI 67.5% to 68.3%) reported at least one of 13 gastrointestinal symptoms. The most frequent symptoms were bloating (40%), abdominal rumbling (40%), abdominal pain (17%), acid regurgitation (13%), heartburn (12%), diarrhoea (12%), nausea (12%), and constipation (10%). Half of the participants (50%) had a regular defaecation pattern (defined as generally the same stool consistency and stool frequency) consisting of Bristol Stool Form Scale 4 stools 1-3 times per day. Symptom phenotypes and their prevalence among 51 820 near-complete case participants were as follows: (1) no gastrointestinal symptoms (32%); (2) bloating and/or rumbling only (21%); (3) acid regurgitation and/or heartburn only (4%); (4) any other one or two symptoms (14%); (5) any three or four symptoms (18%); (6) any five or six symptoms (7%); (7) at least seven symptoms (3%). The acid regurgitation and/or heartburn only phenotype associated with obesity, and the remaining symptomatic phenotypes were associated with female sex, decreasing age, and an irregular defaecation pattern, even after excluding individuals with self-reported irritable bowel syndrome, lactose intolerance, or gluten intolerance.CONCLUSION: Most healthy adults, especially women younger than 50 years, experience gastrointestinal symptoms. Symptom phenotypes strongly correlate with sex, age, and bowel habits.

KW - Humans

KW - Female

KW - Male

KW - Denmark/epidemiology

KW - Cross-Sectional Studies

KW - Adult

KW - Blood Donors/statistics & numerical data

KW - Middle Aged

KW - Gastrointestinal Diseases/epidemiology

KW - Prevalence

KW - Defecation/physiology

KW - Surveys and Questionnaires

KW - Young Adult

KW - Constipation/epidemiology

KW - Abdominal Pain/epidemiology

KW - Heartburn/epidemiology

KW - Phenotype

KW - Adolescent

KW - Aged

KW - IRRITABLE BOWEL SYNDROME

KW - FUNCTIONAL BOWEL DISORDER

KW - GASTROINTESTINAL FUNCTION

KW - EPIDEMIOLOGY

UR - https://www.scopus.com/pages/publications/85217448165

U2 - 10.1136/bmjgast-2024-001518

DO - 10.1136/bmjgast-2024-001518

M3 - Journal article

C2 - 39922565

SN - 2054-4774

VL - 12

JO - BMJ Open Gastroenterology

JF - BMJ Open Gastroenterology

IS - 1

M1 - e001518

ER -

Gastrointestinal symptoms and bowel habits in 53 046 healthy Danish blood donors: a nationwide cross-sectional study

Abstract

Keywords

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