Multicultural aspects in functional gastrointestinal disorders (FGIDs)

Cross-cultural factors are important in functional gastrointestinal disorders (FGIDs). In the setting of FGIDs, the aims of this review were as follows: (1) to engender interest in global aspects; (2) to gain a clearer understanding of culture, race, and ethnicity, and their effect on patient care and research; (3) to facilitate cross-cultural clinical and research competency; and (4) to improve and foster the quality and conduct of cross-cultural, multinational research. Cultural variables inevitably are present in the physician-patient context. Food and diets, which differ among cultural groups, are perceived globally as related to or blamed for symptoms. From an individual perspective, biological aspects, such as genetics, the microbiome, environmental hygiene, cytokines, and the nervous system, which are affected by cultural differences, all are relevant. Of equal importance are issues related to sex, symptom reporting and interpretation, and family systems. From the physician's viewpoint, understanding the patient's explanatory model of illness, especially in a cultural context, affects patient care and patient education in a multicultural environment. Differences in the definition and use of complementary and alternative medicine and other issues related to health care services for FGIDs are also a relevant cross-cultural issue. This article highlights the importance of cross-cultural competence in clinical medicine and research.