The prevalence and risk factors of irritable bowel syndrome in Saudi Arabia in 2019

Prevalence of Irritable Bowel Syndrome (IBS) in the Arab World: A Systematic Review

Irritable Bowel Syndrome (IBS) is a common functional pathology of the gastrointestinal tract (GIT) across the globe. The prevalence rate of IBS varies across the regions. In the present systematic review, we aim to investigate the prevalence of IBS in Arab countries in recent years. To identify relevant studies, a comprehensive search was undertaken in various databases including CINAHL (Cumulated Index to Nursing and Allied Health Literature) Ultimate, Scopus, PubMed, and Web of Science. Furthermore, Google Scholar was also explored to identify relevant studies. The inclusion criteria included studies that assessed IBS in the Arab world and were published in the English language. Fifty-two cross-sectional studies from seven countries, encompassing 51,683 participants, were included. The majority of the included studies were conducted in Saudi Arabia (n=40), followed by Jordan (n=4) and Egypt (n=3). The highest prevalence rates were reported by studies from Saudi Arabia, Lebanon, and Jordan. Low prevalence rates (<20%) were noted in 19 studies included in this systematic review. Female predominance in IBS prevalence was observed in most studies, while only two studies indicated higher prevalence in males. Key risk factors included family history, anxiety, depression, gastroesophageal reflux disease, low income, diabetes, low water intake, workload, occupation, food allergy, smoking, age, chronic diseases, and stress. IBS prevalence in the Arab world varies significantly. Female predominance was seen in the present systematic review as well.

Prevalence and Associated Risk Factors of Irritable Bowel Syndrome Among General Population: A Cross-Sectional Study in Qassim Region, Saudi Arabia

Background Irritable bowel syndrome (IBS) affects 10-20% of the global population, primarily manifesting as functional issues leading to abdominal discomfort. Key contributors like genetics, psychological factors, weakened immunity, and environmental pollutants play significant roles. Regional variations exist, with prevalence rates ranging from 7-10% in certain areas like South Asia and the Middle East to as high as 20% in many Western countries. Objective The objective of this study is to assess the prevalence of irritable bowel syndrome (IBS) and its related risk factors among the general populace of the Qassim region, Saudi Arabia, aiming to offer valuable insights for healthcare planning and intervention strategies. Methods A cross-sectional descriptive study was conducted, utilizing a validated self-administered questionnaire among residents of the Qassim region aged over 18 years. The questionnaire included demographic information about the participants and the validated Rome IV questionnaire for IBS in adults. Ethical approval for the study was obtained from the Qassim Research Ethics Committee, and data analysis was conducted using R script language version 4.3.3. A significance level of p < 0.05 was employed to interpret the results. Results Overall, significant associations were observed between IBS diagnosis and food allergy (AOR = 2.34, 99% CI: 1.27-4.29), family history of IBS (Adjusted Odd Ratio (AOR) = 7.03, 99% CI: 3.51-15.74), and abdominal pain lasting more than six months (AOR = 2.54, 99% CI: 1.49-4.33). Conclusion This study highlights a high IBS prevalence (21.4%) in Saudi Arabia's Qassim region. While no overall soda-IBS link was found, males showed a protective effect. Significant associations were noted between food allergy, family history, and abdominal pain with IBS diagnosis, especially among females. Further research on gender disparities and familial and abdominal pain roles in IBS management is warranted.

Prevalence of Isolated Irritable Bowel Syndrome Among Adults in the Kingdom of Bahrain

BACKGROUND

Irritable bowel syndrome (IBS) is a very common gastrointestinal disorder encountered in clinical practice. In this study, we estimated the prevalence of isolated IBS and its associated demographic factors among the adult population in the Kingdom of Bahrain.

METHODS

A cross-sectional study was conducted targeting adults in Bahrain aged 18 years and above. Individuals with a prior diagnosis of any bowel ailment were excluded. Data was acquired via a self-administered questionnaire. IBS-specific questions were derived from the validated Rome IV diagnostic questionnaire for adults. The scoring methodology inherent to this questionnaire was used for the diagnosis of IBS. The data collection process remained anonymous. Data was compiled using Excel spreadsheets, and the Statistical Package for Social Sciences (SPSS) was employed for analytical purposes. Associations between IBS and demographical or behavioral characteristics were explored using the Chi-square test.

RESULTS

The prevalence of isolated IBS, adopting the Rome IV criteria, was 156 (18.3%) and IBS-M (mixed) type was 40 (38.1%) of these. IBS was predominantly higher among females compared to males (340 vs 235; 22.6% vs 11.9%). The majority of IBS cases (121, 21%) were in the 41-50 age group. A statistically significant association has been demonstrated between IBS and GERD using Pearson's chi-squared test (p-value = 0.000). Similarly, it was linked to indigestion (p-value = 0.00).

CONCLUSIONS

Although the percentage appeared to be significantly higher than the global prevalence of 4% (using Rome IV criteria), our findings were equivalent to the reports conducted in the Middle East region. Integrating holistic patient assessments, including quality of life metrics, along with anxiety, depression, and vitamin D deficiency, will further enhance the understanding of IBS in Bahrain and its impact on the patients and the health services utilization.

Arabic websites assessment of irritable bowel syndrome: How trustworthy are they? A cross-sectional study

Background and Aims

Irritable bowel syndrome (IBS) is a chronic GI disorder that affects people all over the world. Patients frequently look for information about their ailments online. Despite being widely and easily accessible, online information's quality and readability are under doubt. In this investigation, we assessed the effectiveness and usability of IBS Arabic websites found on significant search engines.

Methods

IBS-related search terms in Arabic were entered into two search engines (Google and YouTube), and the first 30 websites per word from Google, and the first 20 websites per word from YouTube were assessed for eligibility. Eligible Google websites were assessed for quality and readability, while YouTube websites were assessed for quality. Quality was assessed using the DISCERN score and the JAMA Benchmark. Readability was assessed using the automatic Arabic readability index (AARI). Associations between quality, readability, types of websites (medical/nonmedical), and video length were analyzed.

Results

For Google: A total of 48 websites were evaluated, mean DISCERN score was 40.4 (SD = 10.28) indicating fair quality. The mean JAMA score was 1.6 (SD = 0.69), with the readability being worse the higher the quality. Medical websites had higher quality scores than nonmedical ones. For YouTube: A total of 34 YouTube videos were evaluated, mean DISCERN score was 34.7 (SD = 7.35), indicating poor quality. The mean JAMA score was 1.4 (SD = 0.72). Medical websites had higher quality scores than nonmedical ones. There was no association between the quality of the videos and their length.

Conclusion

The majority of websites were of low to fair quality and required a high degree of readability. As a result, we advise (1) healthcare practitioners to offer helpful websites to their patients, and (2) the development of IBS-related websites under the guidance of experts, with the involvement of patients.

Assessment of Knowledge, Perception, and Practices Regarding Probiotics and Prebiotics Among Clinicians in Saudi Arabia: A Pilot Study

Probiotics and prebiotics are important in preventing different diseases such as irritable bowel syndrome (IBS), which is a functional bowel disorder characterized by changes in bowel habits. Considering the limited studies on this topic, the present study was conducted to assess both gastroenterologist (GI) physicians' and dietitians' practices in recommending probiotics and prebiotics for IBS patients, as well as to measure their professional educational history on probiotics and prebiotics. A descriptive cross-sectional study was performed to investigate the knowledge, use, and perceptions of probiotics and prebiotics of GI physicians and dietitians at governmental hospitals in Jeddah, Saudi Arabia. A validated questionnaire was sent to 42 participants of both genders selected randomly, who were all qualified healthcare practitioners. The majority of GI physicians demonstrated high levels of knowledge about the health benefits of probiotics and prebiotics (76.2%). In contrast, most dietitians had lower levels of knowledge (52.4%), representing a significant difference between both groups (p<0.01). 83.3% of GI physicians believed that the use of probiotics and prebiotics was required for IBS patients, as compared with 50.0% of dietitians. In conclusion, GI physicians were shown to be more knowledgeable and believed more in the benefits of using probiotics and prebiotics in IBS patients than dietitians, but most participants were not aware of the probiotic products that are available in pharmacies in Saudi Arabia.

Prevalence, Risk Factors, and Management of Irritable Bowel Syndrome in Saudi Arabia: A Systematic Review

The prevalence and associated risk factors of irritable bowel syndrome (IBS) have been a significant area of focus in several studies conducted in Saudi Arabia. These studies have looked at varied populations, including school teachers, university students, and the general populace. The reported prevalence rates for IBS vary substantially across studies, ranging from 7.9% to an astounding 49.3%. The average prevalence noted across these studies is about 24%. The aim of this review is to collate, compare, and analyze data from these studies, hoping to shed light on the key risk factors and demographic trends associated with IBS in Saudi Arabia. This review encompasses data from 20 studies, aggregating information from 17,018 participants. The research methodologies adopted by each of these studies have been analyzed, especially focusing on their sample sizes, which vary significantly. Furthermore, the review incorporates details on the socio-demographic attributes of the participants, including age specifics, gender representation, and geographical distribution within Saudi Arabia. The results demonstrate a wide variability in IBS prevalence among different groups. The overall prevalence of IBS in Saudi Arabia based on the provided data is approximately 24%. Gender-based breakdown in some studies indicated varying prevalence among males and females, which indicated that females are more prone to the disease. The same for certain age groups, specifically between 51 and 60 years, which showed slightly higher rates. Factors such as educational discipline, living conditions, mental health, dietary habits, family history of IBS, and certain comorbidities such as diabetes mellitus were found to influence the occurrence of IBS in different cohorts. Moreover, lifestyle factors such as low water intake, lack of dietary fiber, stress, and even caffeine intake were associated with IBS. Socioeconomic aspects, including family income levels and academic performance, were also hinted to have a potential link with IBS prevalence. In light of the presented data, it is evident that IBS prevalence in Saudi Arabia is influenced by a multitude of factors, ranging from genetic and dietary to psychological and socioeconomic. The substantial variations in prevalence across different cohorts suggest the need for a more nuanced understanding of this condition, specifically tailored to the unique demographics and cultural contexts of Saudi Arabia. Early diagnosis and tailored interventions, considering these multifaceted determinants, are crucial for the effective management of IBS in the region.

Prevalence of Irritable Bowel Syndrome in Saudi Arabia: A Systematic Review and Meta-Analysis

Irritable bowel syndrome (IBS) is a commonly found global functional pathology with no detectable structural changes. It affects the quality of life and often coexists with psychiatric and somatic issues. We reviewed all articles published between 1990 and April 2023. The databases used for the data search were Google Scholar, Web of Science, Cochrane Library, and PubMed/MEDLINE. Ovid search engine was also used to broaden the search strategy. Predefined keywords, including "Irritable bowel syndrome" (MeSH) OR "IBS" (all fields), along with "Saudi Arabia" and "Middle East," were used to avoid data loss and ambiguity. Any cross-sectional study that reported the prevalence of IBS in any gender, age, and group of the Saudi population was included. Data extraction was independently performed in duplicate to mitigate bias and data loss. Statistical analysis of proportion was conducted by using Miller (Freeman-Tukey double arcsine - exact inverse). Out of 350 records identified, only 38 studies were included in the quantitative synthesis. The total number of study participants was 26,567, on the basis of the predefined inclusion criteria of the study. StatsDirect software was used for the statistical analysis of the study parameters. Based on all 38 identified studies, the calculated pooled prevalence was 20.7% (95% confidence interval (CI) = 17.8% to 23.7% by applying random effects (DerSimonian-Laird method). IBS was identified in 21% (95% CI = 16.7% to 25.7%) of the general population, 22% (95% CI = 17.6% to 26.7%) of students, and 18.3% (95% CI = 13.3% to 23.9%) of healthcare workers. The pooled prevalence of IBS among the Saudi population was 20.7%. The pathophysiology of IBS is complexed and significantly affected by genetics, diet, cultural characteristics, age, anxiety, depression, stress, and sleep disorders. This study fills a gap in understanding IBS prevalence in Saudi Arabia, contributing valuable data to this region.

Irritable Bowel Syndrome: Prevalence and Determinants Among Adults in the Makkah Region, Saudi Arabia

BACKGROUND

Irritable bowel syndrome (IBS) is among the most prevalent gut-brain interaction disorders and one of the most expensive in terms of money and health. Despite their widespread occurrence in society, these disorders have only recently been subjected to rigorous scientific inquiry, classification, and treatment. Although IBS does not lead to future complications, such as bowel cancer, it can impact work productivity and health-related quality of life and increase medical costs. Both young and older people with IBS have worse general health than the general population.

AIMS

To determine the prevalence of IBS among adults aged 25 to 55 years in the Makkah region, as well as the risk factors that may contribute to it.

METHODOLOGY

A cross-sectional web-based survey with a representative sample (n = 936) of individuals in the Makkah region was carried out from November 21, 2022, to May 3, 2023.

RESULTS

In Makkah, 420 out of 936 persons have IBS, making it 44.9% common. Most of the IBS patients in the study were women, aged 25 to 35 years, married, and suffering from mixed IBS. Age, gender, marital status, and occupation were found to be associated with IBS. It was discovered that there is an association between IBS and insomnia, medication use, food allergies, chronic diseases, anemia, arthritis, gastrointestinal surgery, and a family history of IBS.

CONCLUSION

The study highlights the importance of addressing the risk factors of IBS and developing supportive environments to alleviate its effects in Makkah. The researchers hope the findings inspire further research and action to improve the lives of people with IBS.

Assessment of Public's Awareness Regarding Irritable Bowel Syndrome in Aseer Region, Saudi Arabia

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by altered bowel habits, abdominal pain, or discomfort. It is a highly prevalent disorder that affects patients' quality of life. A workup is usually required to diagnose IBS, as its differential diagnosis includes some serious conditions such as carcinoma of the colon. The present study aimed to assess the awareness and beliefs of the general population regarding IBS. This study was conducted in the Aseer Region, in the southwestern part of Saudi Arabia. It followed a cross-sectional research design that was conducted during the period from January to March 2021 using a structured self-administered questionnaire to assess the demographic variables in addition to questions to assess participants' awareness and beliefs related to IBS. Following a convenience sample, the study included 779 participants, with 43.3% being male, mostly in the age group 21-30 years (36.7%), and 68.7% being university graduates. Most participants (70.5%) were aware of IBS, and had the correct knowledge about its etiology, symptoms, risk factors, prognosis, and management. It is recommended to conduct various awareness-raising programs regarding IBS to improve the public's knowledge and to decrease functional disabilities and their impact on life.

The Prevalence of Irritable Bowel Syndrome and Its Relation to Psychiatric Disorders Among Citizens of Makkah Region, Saudi Arabia

BACKGROUND AND AIM

Irritable bowel syndrome (IBS) is a chronic functional bowel disorder. Many adults worldwide have symptoms associated with IBS and are responsible for most gastroenterology visits. The aim of this study is to illustrate and analyze the prevalence of IBS among the general population in Makkah Al-Mukarramah city using the Rome IV criteria in relation to psychiatric disorders.

METHODOLOGY

This was a cross-sectional study conducted on Makkah citizens. The study excluded all residents in Makkah without Saudi nationality or below the age of 18. The survey was created using Google forms and shared randomly on social media. The sample size was calculated using the OpenEpi website v3.0. The online questionnaire is composed of three sections: sociodemographic data, Rome IV criteria with the Bristol Stool Scale, and lastly the Depression, Anxiety, and Stress Scale 21 (DASS-21) score for stress, anxiety, and depression. Data were analyzed using SPSS software for Windows V.23, and odds ratio (OR) with 95% confidence intervals (95% CI) was obtained for selected risk factors using logistic regression.

RESULTS

Nine hundred and twenty-one individuals from Makkah city completed the survey. The overall IBS prevalence was 20.19%. The commonest subtypes of IBS were IBS-M followed by IBS-C (53.8% and 22%, respectively). In the multiple regression analysis, stress (P = <0.001, OR = 2.473) was statistically significantly associated with IBS.

CONCLUSION

In this study, the prevalence of IBS among Makkah citizens is high. Stress was found to be a major risk factor for IBS.

Prevalence and Associated Risk Factors of Irritable Bowel Syndrome Among Female Secondary School students in Ar Rass City, Qassim Region

BACKGROUND

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal condition associated with many modifiable and non-modifiable risk factors.

OBJECTIVES

To determine the prevalence of IBS and the associated risk factors among female secondary school students in Ar Rass city, Qassim region, Saudi Arabia.

METHODS

A cross-sectional study was conducted from June to August 2021 among female students attending government secondary schools at Ar Rass city, Qassim region. Two schools were selected by simple random sampling. A self-administered questionnaire using Google Form, submitted to the WhatsApp groups of the students, gathered personal data, and behavioral, lifestyle and health background characteristics of the participants. The questionnaire included Rome IV criteria for IBS diagnosis.

RESULTS

Out of 612 invited students, 429 responded (response rate: 70.1%). Twenty-eight incomplete questionnaires were excluded leading to 401 participants in the final analysis. The mean (± SD) age of study participants was 17.3 (±2.05) years. The overall prevalence of IBS was 21.4% (n=86); 11.7% (n=47) were already diagnosed; however, 9.7% (n=39) were newly detected in our survey. The factors associated with IBS included frequent consumption of soft drinks (p=0.016), low vegetable consumption (p=0.003), poor mental health (p<0.0001), family history of IBS (p<0.0001) and history of chronic disease (p<0.0001).

CONCLUSION

IBS is prevalent among female secondary school students in Ar Rass city. Unhealthy diet and poor mental health are associated with IBS. Creating awareness regarding IBS and about importance of healthy lifestyle is recommended. School staff need to be trained to promote the physical and mental health of the students.