The Prevalence and Risk Factors of Irritable Bowel Syndrome in Saudi Arabia in 2019

Naif H. Alqahtani, Mohammad Eid M. Mahfouz

Abstract


Background: Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal (GI) disorder. The aim of this study is to assess the prevalence of IBS and its risk factors among the general population of Saudi Arabia, as there is no previous study has done so.

Methods: A cross‑sectional study was carried out to evaluate the prevalence of IBS, IBS subtypes and IBS risk factors among the general population of Saudi Arabia from June 22 to November 30, 2019. A designed questionnaire that is based on ROME IV criteria and licensed from Rome Foundation was used. A total of 1,680 eligible individuals from different parts of Saudi Arabia took part in this national survey and were included in the statistical analysis. The statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) program (version 22).

Results: The prevalence of IBS in the study was 18.2%. IBS‑M was the most common subtype among IBS patients (42.3%). Risk factors that are significantly associated with IBS were shown to be smoking habits, gastroesophageal reflux disease (GERD), food allergy, anxiety, psychological stress, family history of IBS, regular use of non‑steroidal anti‑inflammatory drugs (NSAIDs), history of infection before occurrence of symptoms and residence in the south of Saudi Arabia (P < 0.05*).

Conclusions: IBS is prevalent in Saudi Arabia. The most common risk factor among IBS patients is a positive family history of IBS (80%). Raising public awareness and further prospective studies are both advocated and needed.


Keywords


Anti‑bacterial agents; body mass index; contraceptive agents; genetics

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References


Quigley E. Irritable bowel syndrome: A global perspective.

World Gastroenterology Organisation Global Guideline, 2009.

Soares RLS. Irritable bowel syndrome: A clinical review. World

J Gastroenterol 2014;20:12144‑60.

Drossman DA, Camilleri M, Mayer EA, Whitehead WE. AGA

technical review on irritable bowel syndrome. Gastroenterology

;123:2108‑31.

Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC.

Global prevalence of irritable bowel syndrome according to

Rome III or IV criteria: A systematic review and meta‑analysis.

Lancet Gastroenterol Hepatol 2020;5:908‑17.

Shah E, Rezaie A, Riddle M, Pimentel M. Psychological

disorders in gastrointestinal disease: Epiphenomenon, cause or

consequence? Ann Gastroenterol 2014;27:224‑30.

Nojkov B, Rubenstein JH, Chey WD, Hoogerwerf WA. The

impact of rotating shift work on the prevalence of irritable bowel

syndrome in nurses. Am J Gastroenterol 2010;105:842‑7.

Saha L. Irritable bowel syndrome: Pathogenesis, diagnosis,

treatment, and evidence‑based medicine. World J Gastroenterol

;20:6759‑73.

Palsson OS, Drossman DA. Psychiatric and psychological

dysfunction in irritable bowel syndrome and the role of

psychological treatments. Gastroenterol Clin North Am

;34:281‑303.

Halpert A, Drossman D. Biopsychosocial issues in irritable

bowel syndrome. J Clin Gastroenterol 2005;39:665‑9.

Gibson PR, Varney J, Malakar S, Muir JG. Food components and

irritable bowel syndrome. Gastroenterology 2015;148:1158‑74.e4.

Butt AS, Salih M, Jafri W, Yakoob J, Wasay M, Hamid S.

Irritable bowel syndrome and psychiatric disorders in Pakistan:

A case control study. Gastroenterol Res Pract 2012;2012:291452.

Ibrahim NKR, Battarjee WF, Almehmadi SA. Prevalence and

predictors of irritable bowel syndrome among medical students

and interns in King Abdulaziz University, Jeddah. Libyan J Med

;8:21287.

Chirila I, Petrariu FD, Ciortescu I, Mihai C, Drug VL. Diet

and irritable bowel syndrome. J Gastrointestin Liver Dis

;21:357‑62.

Costanian C, Tamim H, Assaad S. Prevalence and factors

associated with irritable bowel syndrome among university

students in Lebanon: Findings from a cross‑sectional study.

World J Gastroenterol 2015;21:3628‑35.

Kalantar JS, Locke GR 3rd, Zinsmeister AR, Beighley CM,

Talley NJ. Familial aggregation of irritable bowel syndrome:

A prospective study. Gut 2003;52:1703‑7.

Saito YA, Zimmerman JM, Harmsen WS, De Andrade M,

Locke GR 3rd, Petersen GM, et al. Irritable bowel syndrome

aggregates strongly in families: A family‑based case‑control

study. Neurogastroenterol Motil 2008;20:790‑7.

Fukudo S, Kaneko H, Akiho H, Inamori M, Endo Y, Okumura T,

et al. Evidence‑based clinical practice guidelines for irritable

bowel syndrome. J Gastroenterol 2015;50:11‑30.

Carroccio A, Brusca I, Mansueto P, Soresi M, D’Alcamo A,

Ambrosiano G, et al. Fecal assays detect hypersensitivity to

cow’s milk protein and gluten in adults with irritable bowel

syndrome. Clin Gastroenterol Hepatol 2011;9:965‑71.e3.

Helvaci MR, Ayyildiz O, Algin MC, Aydin Y, Abyad A,

Pocock L. Irritable bowel syndrome and smoking. World Fam

Med J: Incorporating Middle East J Fam Med 2017;99:1‑5.

Stasi C, Rosselli M, Bellini M, Laffi G, Milani S. Altered

neuro‑endocrine‑immune pathways in the irritable bowel

syndrome: The top‑down and the bottom‑up model.

J Gastroenterol 2012;47:1177‑85.

Matricon J, Meleine M, Gelot A, Piche T, Dapoigny M,

Muller E, et al. Associations between immune activation,

intestinal permeability and the irritable bowel syndrome. Aliment

Pharmacol Ther 2012;36:1009‑31.

Koloski NA, Talley NJ, Boyce PM. A history of abuse in

community subjects with irritable bowel syndrome and functional

dyspepsia: The role of other psychosocial variables. Digestion

;72:86‑96.

Koloski NA, Jones M, Kalantar J, Weltman M, Zaguirre J,

Talley NJ. The brain‑gut pathway in functional gastrointestinal

disorders is bidirectional: A 12‑year prospective population‑based

study. Gut 2012;61:1284‑90.

Palsson OS, Whitehead WE, Van Tilburg MA, Chang L,

Chey W, Crowell MD, et al. Development and validation of the

Rome IV diagnostic questionnaire for adults. Gastroenterology

;150:1481‑91.

Alharbi SH, Alateeq FA, Alshammari KI, Ahmed HG. IBS

common features among Northern Saudi population according to

Rome IV criteria. AIMS Med Sci 2019;6:148‑57.

Lovell RM, Ford AC. Global prevalence of and risk factors for

irritable bowel syndrome: A meta‑analysis. Clin Gastroenterol

Hepatol 2012;10:712‑21.e4.

Lovell RM, Ford AC. Effect of gender on prevalence of irritable

bowel syndrome in the community: Systematic review and

meta‑analysis. Am J Gastroenterol 2012;107:991‑1000.

Cañón M, Ruiz AJ, Rondón M, Alvarado J. 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. Ann Gastroenterol 2017;30:67‑75.

Han SH, Lee OY, Bae SC, Lee SH, Chang YK, Yang SY,

et al. Prevalence of irritable bowel syndrome in Korea:

Population‑based survey using the Rome II criteria.

J Gastroenterol Hepatol 2006;21:1687‑92.

Abdulmajeed A, Rabab MA, Sliem HA, Hebatallah NE. Pattern

of irritable bowel syndrome and its impact on quality of life in

primary health care center attendees, Suez governorate, Egypt.

Pan Afr Med J 2011;9:5.

Mansouri A, Rarani MA, Fallahi M, Alvandi I. Irritable

bowel syndrome is concentrated in people with higher

educations in Iran: An inequality analysis. Epidemiol Health

;39:e2017005.

Farzaneh N, Ghobaklou M, Moghimi‑Dehkordi B, Naderi N,

Fadai F. Effects of demographic factors, body mass index, alcohol

drinking and smoking habits on irritable bowel syndrome: A case

control study. Ann Med Health Sci Res 2013;3:391‑6.

Modabbernia MJ, Mansour‑Ghanaei F, Imani A,

Mirsafa‑Moghaddam SA, Sedigh‑Rahimabadi M,

Yousefi‑Mashhour M, et al. Anxiety‑depressive disorders among

irritable bowel syndrome patients in Guilan, Iran. BMC Res

Notes 2012;5:112.

Sorouri M, Pourhoseingholi MA, Vahedi M, Safaee A,

Moghimi‑Dehkordi B, Pourhoseingholi A, et al. Functional

bowel disorders in Iranian population using Rome III criteria.

Saudi J Gastroenterol 2010;16:154‑60.

Khademolhosseini F, Mehrabani D, Nejabat M, Beheshti M,

Heydari ST, Mirahmadizadeh A, et al. Irritable bowel syndrome

in adults over 35 years in Shiraz, southern Iran: Prevalence and

associated factors. J Res Med Sci 2011;16:200‑6.

Pickett‑Blakely O. Obesity and irritable bowel syndrome:

A comprehensive review. Gastroenterol Hepatol (N Y)

;10:411‑6.

Nam SY, Ryu KH, Park BJ. Irritable bowel syndrome is

associated with gastroesophageal reflux symptom but not erosive

esophagitis. J Neurogastroenterol Motil 2013;19:521‑31.

Yarandi SS, Nasseri‑Moghaddam S, Mostajabi P, Malekzadeh R.

Overlapping gastroesophageal reflux disease and irritable

bowel syndrome: Increased dysfunctional symptoms. World J

Gastroenterol 2010;16:1232‑8.

Sansone RA, Sansone LA. Irritable bowel syndrome:

Relationships with abuse in childhood. Innov Clin Neurosci

;12:34‑7.

Basandra S, Bajaj D. Epidemiology of dyspepsia and irritable

bowel syndrome (IBS) in medical students of Northern India.

J Clin Diagn Res 2014;8:JC13‑6.

Keszthelyi D, Dackus GH, Masclee GM, Kruimel JW,

Masclee AA. Increased proton pump inhibitor and NSAID

exposure in irritable bowel syndrome: Results from a case‑control

study. BMC Gastroenterol 2012;12:121.

Kerckhoffs APM, Akkermans LMA, de Smet MBM,

Besselink MG, Hietbrink F, Bartelink IH, et al. Intestinal

permeability in irritable bowel syndrome patients: Effects of

NSAIDs. Dig Dis Sci 2010;55:716‑23.

Al‑Turki YA, Aljulii MZ, Al Murayshid A, Al Omaish HR,

Al Daghiri KS, Al Seleemi AY, et al. Prevalence of irritable

bowel syndrome among students in King Saud University,

Riyadh, Saudi Arabia. Middle East J Fam Med 2011;9:17‑20.

Hasler WL, Schoenfeld P. Systematic review: Abdominal and

pelvic surgery in patients with irritable bowel syndrome. Aliment

Pharmacol Ther 2003;17:997‑1005.