Bloating and Distention Patients Form 6 Distinct Latent Clusters Based on Symptoms, Diet, Psychosocial, and Quality-of-Life Parameters
Bibliographic record
Abstract
INTRODUCTION: Bloating, distention, and gas-related gastrointestinal (GI) symptoms are frequently reported by patients across the spectrum of disorders of gut-brain interaction (DGBI). We aimed to characterize these using latent class modeling in a large multinational survey. METHODS: A nationwide survey of adults in the United States, United Kingdom, and Mexico used quota sampling for demographic balance. It included Rome IV diagnostic questions, Intestinal Gas Questionnaire, Patient Health Questionnaires for anxiety and depression (PHQ-4) and somatization (PHQ-12), quality of life (PROMIS Global-10), and lifestyle questions. Latent class analysis was performed using "depmix" in RStudio 4.2.3. RESULTS: A total of 3,471 subjects experiencing bloating and/or distention (mean age 43 years, 57% female) were included. Using 42 demographic and pertinent clinical variables, latent class analysis revealed 6 distinct clusters. The first 2 clusters demonstrated limited-to-moderate impairment in health-related quality of life (HRQoL), with both characterized by some degree of dietary and supplement associations; however, cluster 2 lacked specific triggers observed in other clusters. The subsequent 2 clusters showed favorable HRQoL and mild gas-related symptoms, with only cluster 4 exhibiting distinct dietary triggers. The final 2 clusters, associated with bowel dysfunction, showed a higher prevalence of irritable bowel syndrome (IBS) with constipation and IBS mixed in cluster 5, and IBS with diarrhea in cluster 6. These bowel dysfunction clusters exhibited severe gas symptoms in the preceding 24 hours and greater HRQoL impairment compared with the other 4 clusters. Notably, cluster 5 was linked to dietary triggers, whereas cluster 6 was defined by psychosocial comorbidities. DISCUSSION: Bloating and distention patients are likely driven by variable influences of dietary, psychological, and bowel dysfunction. Further studies are needed to identify mechanisms and titrate treatment suited to specific mechanistic drivers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".