Prevalence of irritable bowel syndrome in Chinese college and university students assessed using Rome III criteria

Food contributing to fermentable oligosaccharide, disaccharide, monosaccharide, and polyols intake in Korean adults

BACKGROUND/OBJECTIVES

The dietary intake of foods with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is known to adversely affect patients with irritable bowel syndrome (IBS). However, the effects of FODMAP have been studied predominantly among Western populations. This study aimed to identify foods high in FODMAP content which form a part of the Korean adult diet and obtain basic data for the preparation of IBS guidelines.

SUBJECTS/METHODS

An online survey of 1,000 adults from the general population in the age group of 20 to 40 years was performed. Data from 787 participants (men, 386; women, 401) were analyzed. The general characteristics of the participants, health status, IBS diagnosis using the Rome III diagnostic criteria, semi-quantitative food frequency questionnaire findings, and food items causing symptoms were analyzed.

RESULTS

Overall, 169 participants (21.5%) had IBS. The contribution of the FODMAP nutrients in both IBS and healthy groups was as follows: fructan > lactose > excess fructose > sorbitol > mannitol > galacto-oligosaccharides (GOS). The fructan intake was 4.6 ± 2.2 g/day and 4.3 ± 2.5 g/day in the IBS and healthy groups (P = 0.014), respectively. In the IBS group, the ratio of the intake of fructan to the total FODMAP intake was 39.5%, 29.8%, and 5.8% through onions, garlic, and bananas, respectively.

CONCLUSIONS

Fructan was the FODMAP nutrient most consumed by Korean adults. Therefore, given the difference in the dietary habits of each country's population, the dietary guidelines for IBS should be country specific.

[Prevalence Survey of Functional Dyspepsia and Irritable Bowel Syndrome in Chinese College Students Based on Rome Ⅳ Diagnostic Criteria]

Objective

To investigate the prevalence and risk factors of functional dyspepsia (FD) and irritable bowel syndrome (IBS) among college students in China.

Methods

An online questionnaire survey of college students aged 17-35 from across China was conducted. The online questionnaire survey was supplemented by an offline survey. A total of 2025 valid samples were included for statistical analysis. χ 2 test and logistic regression were performed for statistical analysis.

Results

The prevalence of FD among college students who met the Rome Ⅳ diagnostic criteria was 5.5% (112/2025), with most of them, or 66.1% (74/112), suffering from postprandial discomfort syndrome (PDS). Smoking (odds ratio [ OR]=2.334, 95% confidence interval [ CI]: 1.187-4.589, P=0.014), depression ( OR=2.447, 95% CI: 1.421-4.214, P=0.001), and insomnia ( OR=1.947, 95% CI: 1.291-2.937, P=0.001) were positively correlated with the prevalence of FD. The prevalence of IBS was 1.9% (38/2025), with IBS-diarrhea dominant (IBS-D) being the most important subtype that accounted for 44.7%. Anxiety ( OR=3.63, 95% CI: 1.34-9.88, P=0.012) and insomnia ( OR=2.35, 95% CI: 1.18-4.68, P=0.015) were positively correlated with the prevalence of IBS.

Conclusion

Based on Rome Ⅳ criteria, IBS and FD are not uncommon among Chinese university students. Psychological disorders and some related lifestyle factors may be related to the development of the disease. In the future, more series of studies based on different diagnostic criteria, different regions, and multiple factors should be conducted in China.

Irritable bowel syndrome in adults: Prevalence and risk factors

Introduction

The prevalence of irritable bowel syndrome (IBS) ranges from 7 to 18% over the world. We aimed to assess the prevalence and risk factors of irritable bowel syndrome in adults.

Methodology

We conducted a cross-sectional study of IBS prevalence and risk factors from March to May 2022 at KRL Hospital Islamabad. 300 people were given Pre-validated Performa's. Our research adheres to the principles outlined in the Helsinki Declaration. The PSS was used to measures how much stress a person has felt in the past month.

The higher the score, the more stressed the person appears to be. A variety of mental health disorders can be evaluated using this method. Data on dietary and lifestyle factors associated with IBS for the last 12 months was also collected from the participants.

Results

The majority of patients, 70%, were classed as Grade 1 and 146 (48.66%) reported abdominal pain associated with defecation. 162 (54%) individuals reported high levels of tea consumed, 81 (27%) consumed coffee and 57 (19%) reported carbonated drinks consumed. 139 individuals reported having Vigorous-Intensity activity, out of which 69 (49.64%) spend 60 min of vigorous activity in a day.

Conclusion

Screening patients for IBS on a regular basis is critical, especially in the younger demographic. If a patient experiences any symptoms of IBS, they should contact their doctor immediately. Consider the care of patients with chronic gastrointestinal complaints, particularly in women and those at greater risk of developing the illness.

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Perceived Stress Scale (PSS) measures how much stress a person has felt in the past month.

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The Chalder Fatigue Scale (CFS) is used to measure fatigue.

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We recommend the younger population to be screened for IBS on a regular basis.

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Persistent gastrointestinal symptoms, especially women and those at high risk of the condition, it is critical to take this into account.

ASSOCIATION BETWEEN PSYCHOLOGICAL UPSET AND IRRITABLE BOWEL SYNDROME AMONG NURSING STUDENTS AT KSA

Irritable bowel syndrome (IBS) is a fairly common disorder that occurs in the general population. IBS is a functional bowel disorder associated with decreased work productivity. The aim of this study is to investigate the relationship between psychological upset and irritable bowel syndrome among nursing students at the Hafr Albatin University king Saudi Arabia. A descriptive cross-sectional research design on 223 student nurses from Hafr Al Batin university. One tool is divided into three main parts; demographic data, student's psychological upset, and irritable bowel syndrome manifestations sheet. According to the results of the study there is a statistically significant correlation between students' psychological stiffness and manifestations of irritable bowel syndrome (p

Prevalence and risk factors of functional gastrointestinal disorders in early period medical students: a pilot study in Tunisia

Functional gastrointestinal disorders (FGIDs) are highly prevalent in medical students around the world. However, there is no specific data on FGIDs in Tunisia. The objectives of this study were to evaluate the prevalence of FGIDs in medical students according to the rome III criteria and to identify risk factors associated with these disorders. A self-administered questionnaire survey was carried out among the students from the first and the second year of medical studies. We studied the influence of socio-demographic characteristics, lifestyle, health care seeking, psychosomatic symptoms and hospital anxiety and depression scale on the prevalence of FGIDs among these students. Three hundred and forty-three students (20.3 ± 0.8years) were included in our study. The prevalence of FGIDs was 54.2%. The main FGIDs found were the unspecified functional bowel disorder (46.6%), functional constipation (11.6%), irritable bowel syndrome (7.6%) and functional dyspepsia (6.7%). In logistic regression, abnormal BMI (OR = 2.1, 95% CI= 1–4.3), living in school dormitory (OR = 3.7, 95% CI = 1.7–7.8), low water intake (OR = 2.2, 95% CI = 1.1–4.2), digestive medication use (OR = 3.4, 95% CI= 1.3–8.5), and probable or definite anxiety (OR = 2.5, 95% CI = 1.1–5.8) were the five risk factors associated with FGIDs. We demonstrate a high prevalence of FGIDs (54.2%) among our students. Risk factors for FGIDs were abnormal BMI, living in school dormitory, low water intake, digestive medication use and anxiety.

The Prevalence of Irritable Bowel Syndrome Among Chinese University Students: A Systematic Review and Meta-Analysis

Background

Irritable bowel syndrome (IBS) has become a common public health issue among university students, impairing their physical and mental health. This meta-analysis aimed to examine the pooled prevalence of IBS and its associated factors among Chinese university students.

Methods

Databases of PubMed, EMBASE, MEDLINE (via EBSCO), CINAHL (via EBSCO), Wan Fang, CNKI and Weipu (via VIP) were systematically searched from inception date to May 31, 2021. Meta-analysis was performed using random-effects models. Meta-regression and subgroup analysis were used to detect the potential source of heterogeneity.

Key Results

A total of 22 cross-sectional studies (14 were in Chinese and 8 were in English) with 33,166 Chinese university students were included. The pooled prevalence of IBS was estimated as 11.89% (95% CI = 8.06%, 16.35%). The prevalence was 10.50% (95% CI = 6.80%, 15.87%) in Rome II criteria, 12.00% (95% CI = 8.23%, 17.17%) in Rome III criteria, and 3.66% (95% CI = 2.01%, 6.60%) in Rome IV criteria. The highest prevalence of IBS was 17.66% (95% CI = 7.37%, 36.64%) in North China, and the lowest was 3.18% (95% CI = 1.28%, 7.68%) in South China. Subgroup analyses indicated that gender, major, anxiety and depression symptoms, drinking and smoking behaviors were significantly associated with the prevalence of IBS. Meta-regression analyses suggested that region influenced prevalence estimates for IBS.

Conclusions and Inferences

This meta-analysis illustrated that IBS is very common in Chinese university students. Regular screening, effective prevention, and appropriate treatments should be implemented to reduce the risk of IBS in this population. More future studies should be conducted in Northeastern and Southwestern parts of China.

The prevalence of chronic pain in young adults: a systematic review and meta-analysis

ABSTRACT

Prior systematic reviews have summarized the prevalence and impact of chronic pain in "average" pediatric (i.e., school-age) and adult (i.e., middle-age) age groups. To our knowledge, this is the first study to describe the prevalence of chronic pain in the subgroup of individuals that fall in between established boundaries of "childhood" and "adulthood" - known as young adulthood. The goal of this research was to meta-analyze prevalence data on pain in young adults based on available data published between 2008 and 2020. Searches were identified with MEDLINE, Embase, and PsycINFO. We included general population and university-based studies presenting prevalence estimates of chronic pain (pain lasting ≥3 months) in young adults. We identified 43 articles providing prevalence estimates across a combined population of 97,437 young adult respondents (age range: 15-34), with studies undertaken in 22 countries. Available data allowed for stratification of prevalence according to pain condition. The overall pooled random-effect prevalence rate of chronic pain in young adults was 11.6%, suggesting that 1 in every 9 young adults experience chronic pain worldwide. Prevalence rates varied considerably according to pain condition. Estimates did not vary according to sex, geographic location, and several study methodological characteristics (i.e., population type, sampling area, sampling year, investigation period, assessment method). Overall, young adult chronic pain is common and should be recognized as a major public health concern. Considering the difficulties young adults face accessing adult healthcare, greater attention is needed to develop transition programs and evidence-based treatments tailored to the unique needs of this age group.

Beverages intake and functional bowel disorders: A cross-sectional study in first-year undergraduates

OBJECTIVE

In this study we aimed to assess the prevalence of functional bowel disorders (FBD) in a group of Chinese first-year undergraduates and the association between common beverage intake and FBD.

METHODS

A cross-sectional survey was conducted among first-year undergraduates in Huazhong University of Science and Technology (Wuhan, Hubei Province, China). In total, 3102 questionnaires on their lifestyle, dietary habits and gastrointestinal symptoms were collected and analyzed. FBD was diagnosed based on the Rome IV criteria. A logistic regression analysis was performed to compare the differences in beverage intake in participants with and without FBD in order to identify possible risk factors for FBD.

RESULTS

The overall prevalence of FBD was 7.64%. The logistic regression analysis showed that those who drank coffee at a frequency of once a month to thrice a week had a higher prevalence of FBD than those who drank it less than once a month (odds ratio 1.405 [95% confidence interval 1.013-1.949]) after adjusted for age, sex, sleep quality, exercise, stress and other dietary habits. However, a further increase in coffee consumption did not lead to an elevated prevalence of FBD.

CONCLUSIONS

Among the first-year undergraduates, FBD affected 7.64% of them. Coffee consumption might be related to an increased prevalence of FBD.

High-Fat Foods and FODMAPs Containing Gluten Foods Primarily Contribute to Symptoms of Irritable Bowel Syndrome in Korean Adults

Dietary control plays an important role in the treatment of irritable bowel syndrome (IBS). However, few studies have examined the relationship between dietary intake and symptoms of IBS in Koreans. The current cross-sectional study aimed to examine the diet in food consumption and nutrient intake in Korean adults aged 20 to 40 with IBS. The data collected were completed by 857 subjects using a community-based web survey. The questionnaire covered functional bowel disorders based on Rome III, the semi-quantitative Food Frequency Questionnaire (SQ-FFQ), and the food items causing symptoms. In total, 186 of 857 subjects (21.7%) were diagnosed with IBS. The non-IBS group had a fat intake of 76.9 ± 47.9 g/day, while the IBS group had a fat intake of 86.6 ± 55.1 g/day (p = 0.014). The non-IBS group had a total fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) intake of 12.6 ± 9.7 g/day, whereas the IBS group had a total FODMAP intake of 13.9 ± 9.9 g/day (p = 0.030). Foods that contributed to the onset of symptoms in the IBS group were instant noodles (70.8%), Chinese noodles with vegetables and seafood (68.7%), pizza (67.2%), and black bean sauce noodles (66.3%) which are mostly classified as high fat and high gluten foods. The dietary intake of IBS patients differs from that of non-IBS subjects. Increased intake of gluten-containing or high-fat foods due to the westernized diet caused more IBS symptoms than high FODMAPs and dairy products in Korean adults in their 20 s to 40 s.

Exploring Quality of Life, Stress, and Risk Factors Associated with Irritable Bowel Syndrome for Female University Students in Taiwan

Irritable bowel syndrome (IBS) is a common recurrent functional gastrointestinal disorder that impacts on patients physically and mentally. Studies on IBS have focused on adults, yet few studies have examined IBS among female university students. The aim of this study was to investigate the prevalence of IBS for female university students and its related factors. Using a cross-sectional study design, a total of 2520 female university students were recruited in southern Taiwan. The structured questionnaires, including the Rome III IBS diagnostic questionnaire, IBS symptom severity scale, Perceived Stress Scale, and World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) were used for data collection. A total of 1894 female students complete the questionnaires. The response rate was 75.15%. The results indicated 193 female students with IBS and the prevalence of IBS was 10.1%. IBS female students had higher levels of stress and lower QOL than non-IBS female students. The risk factors for female university students developing IBS were dysmenorrhea, food avoidance, class absenteeism, and the lower physical domain of QOL. It is advised to consider these factors when providing students with counselling and relevant services in the expectation of alleviating their IBS symptoms, reducing the incidence rate of IBS, and further improving their QOL.

Paediatric functional abdominal pain disorders

Paediatric functional abdominal pain disorders, currently referred to as disorders of gut-brain interaction, comprise irritable bowel syndrome, functional dyspepsia, abdominal migraine and functional abdominal pain not otherwise specified, as defined by the Rome IV diagnostic criteria. Functional abdominal pain disorders are common disorders with a prevalence of 3-16% depending on country, age and sex. A greater understanding of aetiopathogenesis and pathophysiology is emerging and includes intestinal components (inflammation, motility and the microbiota), central factors (psychological aspects, sensitization and/or differences in connectivity or activity of certain brain regions) as well as extrinsic factors (infections). In particular, the timing of disruption of the microbiota-gut-brain axis seems to be important. Diagnosis is challenging but is primarily based on clinical symptoms and exclusion of other organic causes, with an emphasis on avoiding unnecessary invasive diagnostic procedures. The available pharmacological interventions are limited in children and, therefore, management has focused on combined approaches, including mind-targeted interventions (hypnotherapy and cognitive behavioural therapy), diet (probiotics) and percutaneous electrical nerve field stimulation. The evidence for their clinical efficacy, although limited, is favourable, with positive impacts on symptoms and overall quality of life. The coming decades hold promise for improved understanding and management of these enigmatic disorders.

Cohort Profile: The Christchurch IBS cOhort to investigate Mechanisms FOr gut Relief and improved Transit (COMFORT)

BACKGROUND AND AIMS

This cross-sectional observational case-control study was initiated in July 2016 with the aim of increasing an understanding of the underlying disease mechanisms in functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS), functional diarrhoea (FD), and functional constipation (FC). Specific areas of interest include the effect of food, microbiome, host and microbial genetics, metabolome, and psychological variables on unexplained chronic gastrointestinal (GI) symptoms.

METHODS

This study recruited consecutive patients who were attending one of two endoscopy centres in Christchurch, New Zealand, for colonoscopy and a subgroup of participants from the general public who did not undergo colonoscopy. Participants with known GI disease other than an FGID were excluded. Those with symptoms were recruited as cases, whilst those without symptoms were recruited as controls. In the days prior to preparation for colonoscopy, or an agreeable time for those not undergoing colonoscopy, demographic, symptom, psychological, dietary, and health data were collected in addition to biological samples (breath, faeces, blood, and urine). Colonic biopsies were taken at the time of colonoscopy from participants in the colonoscopy subgroup.

RESULTS

Between July 2016 and December 2018, 349 participants were recruited, 315 of whom completed the study, 220 participants were from the colonoscopy subgroup, and 95 from the non-colonoscopy subgroup. This included 129 controls and 186 cases (57 IBS-diarrhoea predominant, 30 IBS-constipation predominant, 41 IBS-mixed, 42 FC, and 16 FD). The mean age of FGID cases was 53.4 years and controls 54.4 years. Cases (149/186, 80.1%) and controls (57/72, 55.8%) were predominantly female. Education levels were similar across the cohort. Smoking and alcohol rates were also similar. Biological samples were collected as planned from participants.

CONCLUSIONS

The COMFORT cohort is a unique clinical cohort of FGID cases and controls with a wide range of demographic, dietary, clinical, psychological, and health data in addition to biological samples. Future research will aim to use a systems biology approach to establish the potential role of diet, host-microbiome interactions, and other factors in the pathogenesis of FGIDs.

Factors associated with irritable bowel syndrome among medical students at Ain Shams University

BACKGROUND

Irritable bowel syndrome (IBS) is one of the most common and potentially disabling gastrointestinal disorders. The pathogenesis of this disorder remains obscure. However, many etiological explanations point toward bacterial etiology. Also, several studies have documented that psychological and social factors may play a role. Medical education is among the most challenging and stressful education, and this may predispose to high rates of IBS.

OBJECTIVES

The aims of this study are to estimate the frequency of IBS in a selected sample of students of Faculty of Medicine in Ain Shams University and to find out the determinants associated with this disorder.

STUDY DESIGN

A cross-sectional study was carried out among medical students from October 2017 to February 2018 at Faculty of Medicine-Ain Shams University. All participants were asked to complete a confidential self-administered questionnaire. An interview questionnaire was used for diagnosis of IBS according to Rome III criteria, while morbid anxiety and depression were diagnosed by using the Arabic version of Hospital Anxiety and Depression Scale (HADS).

RESULTS

Three hundred eighty-two students completed the questionnaire. The frequency of IBS was 31.7% with higher proportion among females and among students with positive family history of IBS. However, IBS was significantly less prevalent among students practicing regular exercise. Lastly, based on (HADS), there was a statistical significant relationship between IBS and anxiety (p < 0.05), but not depression.

CONCLUSION

The study revealed that around 31% of the studied group was suffering from IBS. Female gender, suffering from anxiety, and positive family history of IBS were the main associated factors for IBS. Screening of all medical students in the faculty for IBS is suggested. Providing psychological and emotional support along with stress management is highly recommended.

Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome

BACKGROUND

Irritable bowel syndrome (IBS) is a common and potential disabling functional gastrointestinal disorder. Studies have revealed a possible association between IBS and psychological problems, such as anxiety and depression. Existing systematic reviews have addressed only the levels of anxiety or depression in patients with IBS.

AIM

To investigate systematically the prevalence of anxiety or depression in IBS patients METHODS: A literature search was conducted using the related keywords from the bibliographic databases of Embase, PubMed, Scopus, Web of Science and POPLINE published until 1 January 2019 with no language restriction. Studies reporting the prevalence of anxiety/depressive symptoms/disorders in adult (≥15 years) IBS patients were evaluated. The pooled prevalence, odds ratio (OR) and 95% CI were calculated using stata software.

RESULTS

A total of 14 926 articles were initially screened, and finally 73 papers were included. The prevalence rates of anxiety symptoms and disorders in IBS patients were 39.1% (95% CI: 32.4-45.8) and 23% (95% CI: 17.2-28.8) respectively. The ORs for anxiety symptoms and disorders in IBS patients compared with healthy subjects were 3.11 (95% CI: 2.43-3.98) and 2.52 (95% CI: 1.99-3.20) respectively. The prevalence estimates of depressive symptoms and disorders in IBS patients were 28.8% (95% CI: 23.6-34) and 23.3% (95% CI: 17.2-29.4) respectively. The ORs for depressive symptoms and disorders in IBS patients compared to healthy subjects were 3.04 (95% CI: 2.37-3.91) and 2.72 (95% CI: 2.45-3.02) respectively.

CONCLUSION

Patients with IBS have a three-fold increased odds of either anxiety or depression, compared to healthy subjects.

Psychosocial Factors Associated With Irritable Bowel Syndrome Development in Chinese College Freshmen

Background/Aims

The role of psychosocial factors on irritable bowel syndrome (IBS) in adolescents is incompletely understood. The aim of this study is to investigate the association between the psychosocial factors and the risk of developing IBS in college freshmen.

Methods

A cross-sectional survey was conducted in a randomly selected freshmen population in Wuhan China (n = 2449). Questionnaire evaluated demographics and psychosocial risks. The population was divided into 3 groups: non-discomfort, chronic abdominal discomfort and IBS. The association between the development of IBS and psychosocial factors was analyzed by ordinal and multiple logistic regression analysis.

Results

A total of 2053 (83.8%) completed this survey (mean age, 18.2 ± 0.9 years; female, 35.6%). Among them, 82 (4.0%) fulfilled the Rome III criteria for IBS. Female (odds ratio [OR], 3.31; 95% confidence interval [CI], 2.47-4.45), experience of abuse (OR, 2.44; 95% CI, 1.10-5.56), and suicidal intention (OR, 2.17; 95% CI, 1.15-4.17) were more likely to have IBS. Compared with chronic abdominal discomfort, however, depression (OR, 5.55; 95% CI, 1.36-22.71) was the only dependent risk factor for IBS.

Conclusion

The prevalence of IBS in college freshmen is 4.0%, and to the freshmen, psychosocial factors such as experience of abuse, depression, and suicidal intention were associated with high risk of developing IBS.

[Clinical profile and factors associated with irritable bowel syndrome among medical students in Cotonou (Benin)]

INTRODUCTION

irritable bowel syndrome (IBS) is a common disorder that often results in general medicine and gastroenterology consultations. This study aims to determine IBS prevalence, to describe its clinical features, to determine its associated factors as well as its impact on the education among medical students in Cotonou.

METHODS

We conducted a cross-sectional, descriptive and analytical study on medical students over the period 1 August-29 September 2017. The diagnostic criteria were: Rome IV, Bristol scale, Cungi scale and HADS score. Data analysis was performed using SPSS 20.0 software.

RESULTS

Out of 315 students included in the study, 44 (14%) had IBS. The factors associated with IBS were female gender (OR [CI 95%] = 2.4 [1.2 - 4.7]; p = 0.00), regular consumption of fatty foods (OR [CI 95%] = 2.0 [1.1 - 3.9]; p = 0.03), high to severe levels of stress (OR [CI 95%] = 2.2 [1.1 - 4.7]; p= 0.02) and moderate to severe state of anxiety (OR [CI 95%] = 1.9 [0.9 - 3.6]; p= 0.04). IBS-related absenteeism was rare (1 case; 2.3%).

CONCLUSION

IBS is common among medical students in Cotonou. The identified modifiable factors associated with IBS were stress, anxiety and regular consumption of fatty foods. No appreciable impact on the education was reported.

The Effects of a Self-Care Program on the Severity of Symptoms and Quality of Life of Patients With Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic disease that needs special self-care strategies. The current study aimed at determining the effects of a self-care program on the severity of symptoms and quality of life of patients with IBS. In this randomized controlled clinical trial, 119 patients were randomly assigned to the experimental (n = 60) and control (n = 59) groups. Patients in both groups received the usual treatment of IBS by a gastroenterologist. The control group did not receive any intervention, whereas the experimental group was trained in the self-care program. The process of implementing the self-care program included designing and determining the content validity of the self-care training package, individual training, the first follow-up call, group training, and the second follow-up call. The instruments for collecting data were IBS-Quality of Life and IBS-Symptom Severity Scale. Two sets of evaluations (before and 2 months after the intervention) were done for both groups. The data were analyzed using SPSS software, Version 16. The results showed that there was not a significant difference between the two groups in the severity of symptoms and quality of life before the intervention (p > .05); however, the 2 groups were significantly different after the intervention (p < .0001). Implementation of the self-care program resulted in the improvement of quality of life and reduction in the symptom severity in the experimental group after the intervention (p < .0001), whereas no significant changes were observed in the control group (p > .05). Hence, the data supports that self-care program was effective in improving the quality of life and reducing the severity of symptoms in patients with IBS.

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

AIM

To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts.

METHODS

In this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts.

RESULTS

Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016).

CONCLUSION

Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

Prevalence of Irritable Bowel Syndrome and its Association with Anxiety among Medical Students at King Saud bin Abdulaziz University for Health Sciences in Riyadh

OBJECTIVE

To quantify the prevalence of Irritable Bowel Syndrome (IBS) among medical students of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and to observe the association between anxiety and IBS.

METHODS

This cross-sectional observational study conducted during academic year 2015-2016 has used two self-administered, pre-validated questionnaires: Depression Anxiety Stress Scales-21 (DASS-21) and Rome III criteria. The sample size was 270, and proportional allocation was used to determine distribution of this sample across study population based on percentages of students in each academic year. Convenience sampling was used to select participants.

RESULTS

The overall prevalence of IBS was 21% (n=57), with a higher prevalence among females (26%, n=23) than males (19%, n=34). IBS was most and least prevalent among first-year students (14%, n=5) and fifth-year students (29%, n=21) respectively. Anxiety levels were normal, mild, moderate, and severe or extremely severe in 39% (n=105), 7% (n=19), 26% (n=70), and 27%. A significant association was found between gender & IBS and anxiety levels & IBS.

CONCLUSION

The prevalence of IBS in this study was 21% and higher among females than males but were highest among fifth-year students for both genders. More than 50% of students had moderate or high levels of anxiety for both genders. The prevalence of IBS was highest among students of 5^th fifth year. The study provides evidence that, as medical students of higher year of their under graduation were having higher level of anxiety which leads to IBS.

Prevalence of irritable bowel syndrome and health-related quality of life in adults aged 18 to 30 years in a Colombian University: an electronic survey

BACKGROUND

We estimated the prevalence of irritable bowel syndrome (IBS) and its impact on patient-reported health-related quality of life (HR-QOL) in a university-based population aged between 18 and 30 years in Bogotá, Colombia.

METHODS

The study had a cross-sectional design. Students, faculty, and staff aged 18-30 years of the Pontificia Universidad Javeriana, Bogotá, Colombia were randomly selected and invited to complete an electronic survey containing the Rome III IBS diagnostic questionnaire and an IBS-specific HR-QOL instrument (IBS-QOL).

RESULTS

A total of 1082 individuals participated in this study. The prevalence of IBS was 24.0% (95% CI 21.3-26.6%). IBS-constipation was the most common subtype (41.9%; 95% CI 35.5-48.4%). The overall IBS-QOL score indicated HR-QOL impairment (72.1/100). IBS-unsubtyped patients had the highest overall HR-QOL (constipation: 70.6; diarrhea: 67.2; mixed: 67.0; unsubtyped: 77.8; P=0.003). IBS non-consulters had higher IBS-QOL "Food Avoidance" scores than IBS consulters (60.3 vs. 45.5; P=0.002).

CONCLUSION

IBS is a prevalent disorder in a university-based population aged 18-30 years and has a significant impact on HR-QOL. IBS-unsubtyped subjects had the highest HR-QOL compared to other subtypes. Food avoidance appears to be a key factor in seeking consultation.

Irritable Bowel Syndrome: A Global Challenge Among Medical Students

Irritable bowel syndrome (IBS) has been identified as one of the more highly prevalent and costly gastrointestinal disorders. Despite its uncertain etiology, risk factors, such as stress and academic load, are well correlated with the prevalence of the disease. Being in one of the most stressful and challenging environments, medical students are predisposed to have high rates of IBS. The socioeconomic burden of the disease on its sufferers is devastating as their quality of life is reduced, mandating additional health care precautions. The aim of this article, therefore, is to review the current literature about IBS among medical students, its prevalence, associated risk factors, and diagnostic criteria. Additionally, different solutions and management options are recommended to control the disease.

Need for Rectal Biopsy for Childhood Constipation Predicts Severity of Illness and Need for Laxatives

OBJECTIVES

This study aimed to examine the long-term clinical outcomes of children with severe constipation, as defined by need for rectal biopsy (RB), and to determine which baseline characteristics were predictors of successful outcome.

METHODS

Children with severe constipation who underwent RB for evaluation of Hirschsprung disease at a tertiary medical center were eligible. A cohort of children with constipation without a history of RB served as controls (matched 2:1 by sex and age). Retrospective chart review of clinic visits was performed at baseline, 3, 6, 12, 18, and 24 months. Successful clinical outcomes were defined as ≥3 bowel movements weekly for ≥4 weeks, with ≤2 fecal incontinence episodes monthly, irrespective of laxative use.

RESULTS

A total of 175 RB children (90 boys, mean age: 6.7 years) were matched to 350 controls. Mean duration of constipation symptoms before intake in the RB group was significantly longer compared with controls (3.7 vs 0.4 years, P < 0.001). By 24 months, the cumulative percentage of children achieving at least 1 period of successful outcome was significantly higher in the control group compared with RB population (73% vs 24%, P < 0.001). Multivariate analysis revealed that younger age (P = 0.001, odds ratio 0.87) and shorter duration of constipation before RB (P = 0.03, odds ratio 0.45) were significant predictors of successful outcome.

CONCLUSIONS

Only one-quarter of patients with severe constipation achieved successful outcome during 2-year follow-up. Younger age and shorter duration of constipation at time of biopsy were predictors of successful outcomes, emphasizing the importance of early diagnosis and initiation of treatment in this population.

Frequency of Irritable Bowel Syndrome Among Healthcare Personnel

This study aims to investigate the frequency of irritable bowel syndrome (IBS) among healthcare professionals. A total of 394 healthcare professionals and 207 individuals who were selected as a control group were included in the study. A questionnaire form containing Rome III diagnostic criteria was administered to health workers and the control group. The study groups were evaluated according to age, gender, occupation, profession, presence of chronic disease, drug usage, smoking, awareness of IBS, alarm symptoms, and the type of IBS they have. Irritable bowel syndrome was diagnosed in 44 healthcare workers and 10 control group participants. Of the 44 healthcare professionals with IBS, 6 had alternate, 13 had constipated-dominant, and 25 had diarrhea-dominant IBS. Of the 10 persons in the control group who were diagnosed as having IBS, 5 were diarrhea-dominant and 5 were constipated-dominant type. Irritable bowel syndrome was more frequent in healthcare professionals than in the control group. Healthcare workers are more prone to IBS due to their stressful working environment.

Irritable bowel syndrome among nurses working in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

BACKGROUND

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that can cause disability and economic burden. Nurses are a vital part of the medical team and their well-being is an important issue. Yet, few studies have been done concerning IBS among nurses.

OBJECTIVES

To determine the prevalence, severity, and predictors of IBS among nurses working at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was conducted among 229 nurses who fulfilled the eligibility criteria. They were selected by stratified random sampling during 2014-2015. A validated, confidential, self-administered data collection sheet was used for collection of personal and sociodemographic data. Rome III Criteria, IBS Severity Scoring System (IBS-SSS), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were included. Both descriptive and inferential statistics were done. A multiple logistic regression analysis was done to determine the predictors of IBS.

RESULTS

The prevalence of IBS among nurses was 14.4%, and IBS-Mixed type was the commonest variety (54.5%). Positive family history of IBS, working in outpatient clinics, having day shift, poor sleep quality, and high anxiety and depression scale scores were significantly associated with IBS. After controlling for confounding factors in regression analysis, the predictors of IBS were food hypersensitivity (aOR=4.52; 95% CI: 1.80-11.33), morbid anxiety (aOR=4.34; 95% CI: 1.49-12.67), and positive family history of IBS (aOR=3.38; 95% CI: 1.12-13.23).

CONCLUSION

The prevalence of IBS was 14.4%. Food hypersensitivity, morbid anxiety, and family history were the predictors of IBS. Screening and management of IBS, food hypersensitivity, and psychological problems among nurses are recommended.

Prevalence and factors associated with irritable bowel syndrome among university students in Lebanon: Findings from a cross-sectional study

AIM: To describe the bowel habits and the prevalence of irritable bowel syndrome (IBS) and to investigate the influence of health behavior and social factors on IBS prevalence in university students.

METHODS: This cross-sectional study was conducted at five major universities in Greater Beirut and its suburbs, between February and June 2014. Using a convenience sample, a total of 813 students aged 18 years old and above participated in this study. Participants were asked to complete a comprehensive anonymous questionnaire which detailed characteristics on socio-demographic, health-related, and lifestyle factors, as well as IBS. The ROME III criteria were used as a tool to ascertain IBS. A χ² test was used to determine differences between categorical variables; stepwise logistic regression was used to measure the association between IBS and its risk factors.

RESULTS: An overall prevalence of IBS of 20% was recorded among university students. The bivariate analysis showed that females were significantly more likely to report having IBS than males (29.1% vs 18.2%, P < 0.01). Those living at the school dormitory or in a private residence (39.5%) were more likely to have IBS than those living with their families (16.3%) (P < 0.01). The multivariate analysis showed that those who had a relatively high family income level (US$ > 2000) were almost 6 times more likely to report having IBS than their counterparts.

CONCLUSION: This is the first study to describe the nature of IBS among young adults in Lebanon. The prevalence of IBS among university students in our sample was higher than that reported in the West.

Prevalence of functional bowel disorders and faecal incontinence: an Australian primary care survey

AIM

Interest in functional bowel disorders (FBDs) and faecal incontinence (FI) has increased amongst coloproctologists. The study aimed to assess the prevalence of FBDs and FI (including its severity) among Australian primary healthcare seekers using objective criteria.

METHOD

A cross-sectional survey was conducted in a primary care setting in Sydney, Australia. A self-administered questionnaire was used to collect demographic information and diagnose FBDs (irritable bowel syndrome, constipation, functional bloating and functional diarrhoea) based on Rome III criteria. The severity of FI was determined using the Vaizey incontinence score. Associations with medical/surgical history and healthcare utilization were assessed.

RESULTS

Of 596 subjects approached, 396 (66.4%) agreed to participate. Overall, 33% had FBD and/or FI. Irritable bowel syndrome was present in 11.1% and these participants were more likely to report anxiety/depression (P < 0.01) and to have had a previous colonoscopy (P < 0.001) or cholecystectomy (P = 0.02). Functional constipation was present in 8.1%, and functional bloating and functional diarrhoea were diagnosed in 6.1%, and 1.5%, respectively. FI was present in 12.1% with the majority (52%) reporting moderate/severe incontinence (Vaizey score > 8). Participants with FI were more likely to have irritable bowel syndrome, urinary incontinence and previous anal surgery (P < 0.01).

CONCLUSION

FBDs and FI are prevalent conditions amongst primary healthcare seekers and the needs of those affected appear to be complex given their coexisting symptoms and conditions. Currently, the majority do not reach colorectal services, although increased awareness by primary care providers could lead to sufferers being referred for specialist management.

A school-based study of irritable bowel syndrome in medical students in beijing, china: prevalence and some related factors

Purpose. To investigate the prevalence and some related factors about irritable bowel syndrome (IBS) in medical students. Methods. A cross-sectional study was carried out from February 2014 to Jun 2014 in Beijing University of Chinese Medicine, Beijing, China. All participants were asked to completed self-administered questionnaires. Results. Seven hundred and sixty-seven medical students (23.26 ± 2.88 years, 25.6% males) completed the survey. The prevalence of IBS was 33.3%, with a high prevalence in women (36.1%). Among the IBS patients, 112 cases were IBS-M (43.9%) and 77.6% had moderately severe IBS. There were no statistical differences between control group and IBS patients in anxiety and depression scores (P > 0.05). The total score of Pittsburgh sleep quality index (PSQI) was significantly higher for medical students with IBS and 35.5% of IBS patients had severe sleep disorder; the scores of child trauma questionnaire (CTQ) and student-life stress inventory (SLSI) were also higher in IBS patients. Sex and sleep disorder were independently associated with IBS (OR, 1.914, 95%CI, 1.281-2.860; OR, 1.143, 95%CI, 1.074-1.216). Conclusion. Our study has many valuable findings and they may provide valuable suggestions for the necessary intervention and treatment measures towards medical students.

Constipation-predominant irritable bowel syndrome: A review of current and emerging drug therapies

Irritable bowel syndrome (IBS) is a highly prevalent medical condition that adversely affects patient quality of life and constitutes a significant economic burden on healthcare resources. A large proportion of patients suffer from the constipation subtype of IBS (IBS-C), most commonly afflicting older individuals and those with a lower socioeconomic status. Conventional pharmacologic and nonpharmacologic treatment options have limited efficacies and/or significant adverse events, which lead to increased long-term health care expenditures. Failure to effectively treat IBS-C patients over the past decades has largely been due to a poor understanding of disease pathophysiology, lack of a global view of the patient, and an inappropriate selection of patients and treatment endpoints in clinical trials. In recent years, however, more effective and safer drugs have been developed for the treatment of IBS-C. The advancement in the area of pharmacologic treatment is based on new knowledge of the pathophysiologic basis of IBS-C and the development of drugs with increased selectivity within pharmacologic classes with recognized efficacies. This narrative review covers the spectrum of available drugs and their mechanisms of action, as well as the efficacy and safety profiles of each as determined in relevant clinical trials that have investigated treatment options for IBS-C and chronic constipation. A brief summary of laxative-based treatment options is presented, followed by up-to-date assessments for three classes of drugs: prokinetics, prosecretory agents, and bile acid modulators.

A cross-sectional study of irritable bowel syndrome in nurses in China: prevalence and associated psychological and lifestyle factors

The prevalence of irritable bowel syndrome (IBS) and associated factors, especially psychological and lifestyle factors, in nurses in China have not been investigated previously. The aims of this study were to assess the prevalence of IBS in nurses, to evaluate whether factors, such as psychological disorders, are associated with IBS, and to determine whether psychological disorders can influence the severity of symptoms of IBS and quality of life (QOL). A cross-sectional study was conducted for Chinese nurses from November 2012 to February 2013. Participants were asked to complete questionnaires. The prevalence of IBS was 17.4%. The revised symptom checklist 90 (SCL-90-R) scores were significantly higher for nurses with IBS than for those without IBS (P<0.001), and no difference in scores between IBS subtypes was found (F=1.893, P=0.142). The scores of QOL for nurses with and without IBS were 77.18±21.93 and 88.44±11.89 (P<0.001), respectively. Psychological disorders did not show statistically significant correlations with severity of symptoms of IBS or QOL. Alcohol consumption, low level of exercise, and psychological disorders were risk factors for IBS. In summary, nurses in China show a high prevalence of IBS. Psychological disorders and some related lifestyle factors are probably responsible for the development of IBS in nurses.

Irritable bowel syndrome in middle-aged and elderly Palestinians: its prevalence and effect of location of residence

OBJECTIVES

The prevalence of irritable bowel syndrome (IBS) around the world is variable, ranging from as little as 1.1 to 45%. Limited studies have been carried out in Arab populations. The aim of this study was to determine the prevalence of IBS and its subtypes in the West Bank, Palestine, and to assess variation by locality of residence.

METHODS

We conducted a population-based, cross-sectional study. Participants were randomly selected from all districts of the West Bank, including cities, villages, and refugee camps, and they were at least 50 years of age. Participants completed the Rome III IBS questionnaire along with demographic data. The primary outcome was the effect of location of residence on the prevalence of IBS. A multivariable logistic regression model was used to assess the difference in IBS prevalence based on locality of residence.

RESULTS

A total of 1,601 people were approached for interview, of which 1,352 agreed to participate (response rate 84%). Most participants (53%; n=637) lived in urban centers. The overall prevalence of IBS was 30% (28-33%). IBS was more common in refugee camps (34%) and in villages (34%) compared with urban centers (27%) (P<0.05). Mixed IBS (IBS-M) was the most common of IBS subtypes (55%, n=244). In a multivariable logistic regression analysis, living in refugee camps (odds ratio (OR) 1.68 (95% confidence interval (CI) 1.14-2.40), P=0.005) and in villages (OR 1.33 (1.02-1.72), P=0.033) was associated with increased odds of having IBS when compared with residents of urban centers. IBS, IBS with constipation, and IBS-M were more common in women than in men (P<0.05).

CONCLUSIONS

The prevalence of IBS among middle-aged and elderly residents of Palestine is high. Residents in refugee camps and rural areas have a higher incidence of IBS than those in urban areas.

Traditional Chinese medicine for treatment of irritable bowel syndrome: An overview of systematic reviews and Meta-analyses

AIM: To evaluate the relevant systematic reviews/meta-analyses that focused on the traditional Chinese medicine (TCM) for treatment of irritable bowel syndrome (IBS).

METHODS: Databases including Cochrane Library, PubMed, AMED, EMbase, CBM, CNKI, VIP and WanFang Data were searched from inception to November 2013 to collect the systematic reviews/meta-analyses that focused on the TCM for IBS. Two reviewers screened the literature according to the inclusion criteria and extracted the data. The AMSTAR was used to evaluate the quality of the included studies, and the GRADE system was used to evaluate the quality of evidence.

RESULTS: A total of 14 relevant systematic reviews/meta-analyses were included, of which 10 evaluated the efficacy of Chinese herbal medicine and 4 evaluated acupuncture and Moxibustion. AMSTAR scores were between 2 and 10 points. The results showed that TCM has advantage over conventional medicine in the treatment of IBS; however, the evidence quality is low.

CONCLUSION: This research can provide some references for TCM treatment of IBS. Based on the quality level of GRADE evidence, the evidence user should make an evidence-based decision according to the real condition. TCM clinical research should, based on its own characteristics, select the appropriate research design methods, further develop high-quality clinical studies for the evaluation of Chinese medicine treatment of IBS and provide the high-quality evidence.

Further validation of the visual analogue scale for irritable bowel syndrome after use in clinical practice

The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, was designed to measure symptoms and the effect of treatment in patients suffering from irritable bowel syndrome. The aim of this descriptive correlational study was to conduct further psychometric validation after the VAS-IBS had been used in clinical practice, translate it into English, and compare the results with controls. Forty-nine patients with irritable bowel syndrome (median age = 38 years old [range, 18-69 years]) were compared with 90 healthy persons (median age = 44 years old [range, 21-77 years]) who served as controls. The patients with irritable bowel syndrome completed 3 questionnaires: the VAS-IBS, the Gastrointestinal Symptom Rating Scale, and the Perception of Change of Symptoms. Controls completed only the VAS-IBS. Results showed that the VAS-IBS is a valid questionnaire that measures the degree of change of symptoms and discriminates between patients who have irritable bowel syndrome from those who do not. It is important to compare the VAS-IBS among different cultural populations so we suggest that the English version of the VAS-IBS should now be used in English-speaking countries and be further tested for validity and reliability with English-speaking patients.

Prevalence and predictors of irritable bowel syndrome among medical students and interns in King Abdulaziz University, Jeddah

BACKGROUND

Irritable bowel syndrome (IBS) is a frequent, costly, and potentially disabling gastrointestinal disorder. Medical education is among the most challenging and the most stressful education, and this may predispose to high rates of IBS.

OBJECTIVE

To determine the prevalence and predictors of IBS among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia.

METHODS

A cross-sectional study was conducted among 597 medical students and interns selected by multistage stratified random sample method in 2012. A confidential, anonymous, and self-administered questionnaire was used to collect personal and sociodemographic data, level of emotional stress, and food hypersensitivity during the past 6 months. Rome III Criteria and the Standardized Hospital Anxiety and Depression Scale were also used.

RESULTS

The prevalence of IBS was 31.8%. Multiple logistic regression analysis revealed that the first predictor of IBS was female gender (aOR=2.89; 95.0% CI: 1.65-5.05). The second predictor was presence of morbid anxiety (aOR=2.44; 95.0% CI: 1.30-4.55). Living in a school dormitory, emotional stress during 6 months preceding the study, and the academic year were the next predictors.

CONCLUSIONS

High prevalence of IBS prevailed among medical students and interns. Female gender, morbid anxiety, living in school dormitory, emotional stress, and higher educational level (grade) were the predictors of IBS. Screening of medical students for IBS, psychological problems, and reducing stress by stress management are recommended.

What indigestion means to the malays?

Despite being a large ethnic group within the South-East Asia, there is a paucity of reported literatures on dyspepsia in the Malay population. Recent population-based studies indicate that uninvestigated dyspepsia, based on the Rome II criteria, is reported in 12.8% and 11.6% of Malays in the urban and rural communities respectively. Organic causes of dyspepsia including upper gastrointestinal tract cancers, its precancerous lesions, and erosive diseases are uncommon which is largely due to an exceptionally low prevalence of Helicobacter pylori infection in this population. On the other hand, functional dyspepsia and irritable bowel syndrome are relatively common in the Malays than expected. Within a primary care setting, functional dyspepsia, based on the Rome III criteria, is reported in 11.9% of Malays, of which epigastric pain syndrome is found to be more common. Married Malay females are more likely to have functional dyspepsia and psychosocial alarm symptoms. Also based on the Rome III criteria, irritable bowel syndrome, commonly overlapped with functional dyspepsia, is reported in 10.9% of Malays within a community-based setting. Rather than psychosocial symptoms, red flags are most likely to be reported among the Malays with irritable bowel syndrome despite having a low yield for organic diseases. Based upon the above observations, "proton pump inhibitor test" is probably preferable than the "test and treat H. pylori" strategy in the initial management of dyspepsia among the Malays.

Rome III survey of irritable bowel syndrome among ethnic Malays

AIM: To survey irritable bowel syndrome (IBS) using Rome III criteria among Malays from the north-eastern region of Peninsular Malaysia.

METHODS: A previously validated Malay language Rome III IBS diagnostic questionnaire was used in the current study. A prospective sample of 232 Malay subjects (80% power) was initially screened. Using a stratified random sampling strategy, a total of 221 Malay subjects (112 subjects in a “full time job” and 109 subjects in “no full time job”) were recruited. Subjects were visitors (friends and relatives) within the hospital compound and were representative of the local community. Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires. Subjects with IBS were sub-typed into constipation-predominant, diarrhea-predominant, mixed type and un-subtyped. Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.

RESULTS: IBS was present in 10.9% (24/221), red flags in 22.2% (49/221) and psychosocial alarm features in 9.0% (20/221). Red flags were more commonly reported in subjects with IBS (83.3%) than psychosocial alarm features (20.8%, P < 0.001). Subjects with IBS were older (mean age 41.4 years vs 36.9 years, P = 0.08), but no difference in gender was noted (P = 0.4). Using univariable analysis, IBS was significantly associated with a tertiary education, high individual income above RM1000, married status, ex-smoker and the presence of red flags (all P < 0.05). In multiple logistic regression analysis, only the presence of red flags was significantly associated with IBS (odds ratio: 0.02, 95%CI: 0.004-0.1, P < 0.001). The commonest IBS sub-type was mixed type (58.3%), followed by constipation-predominant (20.8%), diarrhea-predominant (16.7%) and un-subtyped (4.2%). Four of 13 Malay females (30.8%) with IBS also had menstrual pain. Most subjects with IBS had at least one red flag (70.8%), 12.5% had two red flags and 16.7% with no red flags. The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS.

CONCLUSION: Using the Rome III criteria, IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.

A global perspective on irritable bowel syndrome: a consensus statement of the World Gastroenterology Organisation Summit Task Force on irritable bowel syndrome

Irritable bowel syndrome (IBS) is common in western Europe and North America, and many aspects of its epidemiology, risk factors, and natural history have been described in these regions. Recent data suggest, however, that IBS is also common in the rest of the world and there has been some evidence to suggest some differences in demographics and presenting features between IBS in the west and as it is experienced elsewhere. The World Gastroenterology Organization, therefore, established a Task Force comprising experts on the topic from all parts of the world to examine IBS from a global perspective. IBS does, indeed, seem to be common worldwide though with some significant variations in prevalence rates between regions and countries and there may well be some potentially interesting variations in presenting symptoms and sex distribution. The global map of IBS is far from complete; community-based prevalence data is not available from many areas. Furthermore, while some general trends are evident in terms of IBS impact and demographics, international comparisons are hampered by differences in diagnostic criteria, study location and methodology; several important unanswered questions have been identified that should form the basis for future collaborative research and have the potential to shed light on this challenging disorder.

Subtypes of irritable bowel syndrome on Rome III criteria: a multicenter study

BACKGROUND AND AIM

The aim of this study was to explore the distribution and clinical characteristics of four subtypes of irritable bowel syndrome (IBS) based on Rome III criteria in Chinese.

METHODS

A total of 754 consecutive IBS outpatients from three tertiary hospitals in China were included. Diagnostic criteria were based on Rome II or Rome III.

RESULTS

Among 754 outpatients, 510 (67.6%) patients met the Rome II criteria, 735 (97.5%) patients met the Rome III criteria and 492 (65.3%) patients met both sets of criteria. Among 735 patients who met the Rome III criteria, 66.3% had IBS with diarrhea (IBS-D), 14.7% had IBS with constipation (IBS-C), 4.2% had mixed IBS (IBS-M) and 14.8% had unsubtyped IBS (IBS-U). Most of the IBS-D, IBS-C and IBS-M patients based on the Rome III criteria matched the diarrhea-predominant IBS, constipation-predominant IBS and alternating IBS based on the Rome II criteria, respectively. Among IBS-U patients, 57.0%, 33.3% and 9.7% had constipation-predominant IBS, diarrhea-predominant IBS and alternating IBS, respectively. For IBS-M, the frequencies of bowel movements were stable in 48.4% patients and variable in 51.6% patients. Defecation urgency and straining were most frequent in IBS-M and least frequent in IBS-U patients than other subtypes. About 77.2% of IBS-U patients had abnormal stool frequency (< 3 times/week or > 3 times/day).

CONCLUSION

The Rome III criteria are more sensitive and practical in diagnosing IBS. IBS-D is the most frequent subtype, which is followed by IBS-U, IBS-C and IBS-M. IBS-U is a new subtype, which warrants further studies.

Pathophysiologic findings of irritable bowel syndrome in china

The mechanism of irritable bowel syndrome (IBS) is still incompletely understood in the world although large amount of investigations have been carried out on it. There are many studies on the pathophysiology of IBS in China, which has huge amount of population suffering from IBS with special ethnicity and culture, including Mainland China, Hong Kong and Taiwan. We collected the literatures to show the results and discuss whether there were any differences in the pathophysiologic findings between China and other countries, whether there were any differences among different subtypes and how the pathophysiology correlated with the manifestations of patients. Gene polymorphism, disturbances of gastrointestinal motility, visceral hypersensitivity, intestinal infection and inflammation, psychological disturbances, food hypersensitivity and intolerance, and altered gut microflora were reviewed in this paper. Some conflicting outcomes between China and other countries were noted although most of them were similar.

Are Food Constituents Relevant to the Irritable Bowel Syndrome in Young Adults? - A Rome III Based Prevalence Study of the Korean Medical Students

Background/Aims

Irritable bowel syndrome (IBS) is prevalent in general population. This study investigates the prevalence of IBS in medical college students in Korea as well as the influence of dietary habits and nutritional intake on IBS.

Methods

This study is a cross-sectional study of 319 students (239 males and 80 females, age 22.3 ± 2.5 years) from the 6 grade levels of the Medical College in Korea. All students filled out a self-reported questionnaire for ROME III criteria. They also completed a questionnaire to validate dietary habits and food frequency in Korean.

Results

The overall prevalence of IBS was 29.2% without correlation to age, body mass index and grade level in Medical School. However, the prevalence was significantly higher in females than males (33/80 vs 60/239, P = 0.007). There were no significant differences between the IBS-group and the non-IBS group in aspect of nutrition. Not only the diet habits, but also the daily nutritional intake, and even the breakdown into the 12 micronutrients, yielded no significant differences between the 2 groups.

Conclusions

Twenty-nine percent of the medical college students have IBS with a greater prevalence in females. The dietary habits and nutritional intake of the students might not be associated with IBS.

Epidemiology of IBS

Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder. Because not everyone needs to seek care, population-based studies are needed to truly understand the epidemiology of IBS. About 10% of the population has IBS at any one time and about 200 people per 100,000 will receive an initial diagnosis of IBS over the course of a year. IBS patients are more frequently younger in age, and a female predominance has been observed in Western countries and tertiary care settings. IBS patients commonly report overlapping upper GI, as well as a variety of non-GI, complaints.