Clinical Application of Screening Questionnaires for Disorders of Gut-Brain Interaction in Military Personnel: Results of Own Study and Perspectives for Ukrainian-Language Adaptation of Standardized Tools

Disorders of gut-brain interaction are a heterogeneous group of functional gastrointestinal conditions arising from dysregulation of the gut-brain axis in the absence of structural pathology. Military personnel represent a high-risk group due to chronic combat stress, nutritional disruption, and psychological trauma. The absence of validated Ukrainian-language instruments for assessing these disorders is a relevant scientific gap. Objective. To evaluate the clinical applicability of an original structured questionnaire based on the Rome IV diagnostic criteria for screening disorders of gut-brain interaction in Ukrainian Armed Forces personnel, to analyze the prevalence and trigger factors of disorders by subtype, and to systematize international standardized instruments including the Gastrointestinal Symptom Rating Scale, the Irritable Bowel Syndrome Severity Scoring System, and the short Gastrointestinal Quality of Life Index, regarding prospects for their official Ukrainian-language adaptation. Participants and Methods. This single-center cross-sectional study enrolled 169 military outpatients of the Armed Forces of Ukraine in 2025. An original structured questionnaire (6 sections, 14 items) based on the Rome IV Patient Questionnaire modules and the Bristol Stool Form Scale was applied. Statistical analysis included descriptive methods, 95% Wilson confidence intervals for proportions, Pearson chi-square and Fisher's exact tests for intergroup comparisons, and odds ratios with 95% confidence intervals by Woolf's method. Results. Of 169 patients, 150 were male (88.8%); median age was 43 years (interquartile range 35–50). Abdominal pain was reported by 101 patients (59.8%). Among these respondents, 85.1% experienced food-related pain, while 80.7% reported pain associated with defecation, indicating a substantial clinical overlap between irritable bowel syndrome and functional dyspepsia. According to stool pattern, irritable bowel syndrome with constipation predominance was identified in 23.1% of patients, diarrhoea predominance in 20.7%, mixed type in 16.6%, whereas 38.5% demonstrated a normal bowel pattern. The leading precipitating factors were poor nutrition (93.4%) and sleep disturbances (92.9%). Comparative analysis between constipation-predominant and diarrhoea-predominant irritable bowel syndrome subtypes revealed no statistically significant differences for any parameter (p>0.09). In patients with disorders of gut-brain interaction (any subtype) versus normal pattern, significant associations were found with disordered nutrition (odds ratio 2.87; 95% confidence interval: 1.47–5.58; p=0.001) and prolonged displacement (odds ratio 2.22; 95% confidence interval: 1.14–4.33; p=0.016). Conclusion. The original questionnaire demonstrated acceptable clinical applicability. Nutritional disruption and prolonged displacement emerged as combat-related predictors of disorders of gut–brain interaction. The absence of significant differences between clinical subtypes supports the presence of shared pathophysiological mechanisms. The Gastrointestinal Symptom Rating Scale, the Irritable Bowel Syndrome Severity Scoring System, and the short Gastrointestinal Quality of Life Index appear to be priority instruments for official Ukrainian-language validation.