Journal of Medical Case Reports and Reviews

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  • Submited: December 19, 2018
  • Published: February 6, 2019

Abstract

Abstract

Background: Irritable bowel syndrome is a multi-factorial functional gastrointestinal disorder in which abdominal pain and change in frequency and consistency of stool are symptoms of IBS (but not specific) this disorder appear to be common in the third world.

Aim: to shed light on prevalence of IBS among medical students and to assess the risk factors.

Methodology: A cross sectional study was conducted at a college of medicine in Baghdad, the study was done on convenient sample of students, both male and female.

To achieve this study a questionnaire form was  designed according to Rome’s III criteria, and questions regarding life style. Excel was used for data entry and presentation, Chi square test for risk assessment.

Result: The prevalence of IBS among 300 medical students was 20%. Female sex was significantly associated with IBS.

Conclusion:One fifth of medical students suffer from irritable bowel syndrome  with females were more likely to develop it.

Introduction

Introduction:

Irritable bowel syndrome (IBS) is defined as "a functional gastrointestinal (GI) disorder characterized by abdominal pain and altered bowel habits in the absence of a specific and unique organic pathology, although microscopic inflammation has been documented in some patients. 1 "

The diagnostic criteria for irritable bowel syndrome have evolved since 1979 till 2016 starting from Manning passing through Rome’s criteria I, II, III till IV.2,3 .

Prevalence of irritable bowel syndrome have been estimated to be 30% globally, 30% of them seek medical help. 4

Irritable bowel syndrome has been linked to stress & anxiety which represent a major problem in medical students, it might reflect its high prevalence in this group of people. This makes the screening for irritable bowel syndrome among medical students and the management of stress are necessary.5,6 .

Aim of study:

To shed the light on prevalence of irritable bowel syndrome among medical students and to assess risk factors

Subjects and methods:

A cross section study is conducted that include a convenient sample of medical college students both males and females during a period starting from march 2017 till October 2018.

Data collection was done by using a preformed questionnaire that is composed of questions based on Rome’s III criteria & other questions assessing the habits of students as practicing sports and cigarette smoking, sufficient sleeping hours.

Then data entry was done by Excel, percentages were calculated, tables and figures drawn and association using Chi square test was calculated.

The sample included 300 college students with age range 18-22 years old.

122 students were males, while females were 178, Figure 1.

Figure 1.gender

The prevalence of irritable bowel syndrome in the total sample was 20% as shown in Figure 2 below.

Figure 2.prevalence of irritable bowel syndrome

Several studies have been undertaken in the same era in our neighbouring country (Saudi Arabia) some using Rome III, & others using Rome IV.

The studies that depend upon Rome IV among Saudi medical students showed lower prevalence (15, 18%). 7,8 .

While it was almost similar to its prevalence when depending upon same criteria (Rome III) 21%&even it was doubled in another study using the same criteria (44.5).9,10 .

On the contrary in Almutairi study in which a sample size of 511 Saudi medical students showed a diluted IBS prevalence -per say- occurring as 13% although depending on Rome’s III criteria .11

The association between irritable bowel syndrome and gender was assessed using Chi square test in Table 1 .

Gender IBS No IBS Total
Male 15 107 122
Female 45 133 178
Total 60 240 300
Table 1. Asociation between Irritable Bowel Syndrome (IBS) and gender.

Women show higher prevalence of irritable bowel syndrome than men, this had been documented by a meta-analysis of several studies showed comparable results.12,13 .

The association between smoking and Irritable Bowel Syndrome (IBS) was calculated using Chi square test in table 2.

Smoking occurred in 15 % in the total sample, in

Figure 3.Smoking prevalence in total sample

which 10of them were among irritable bowel syndrome sufferers, Figure 3 Figure 4 .

Figure 4.smoking (No.)in IBS

The association between IBS and smoking was calculated by Chi square test in Table 2 .

Smoking IBS No IBS Total
Smoker 10 35 45
Non -smoker 50 205 255
Total 60 240 300
Table 2.theassociation between Irritable Bowel Syndrome (IBS) and smoking

The association of irritable bowel syndrome with smoking is also not confirmed, supported by ameta-analysis results. 14,15 .

While in Lebanese irritable bowel syndrome is associated with water pipe smoking.16

Sport practice among total sample is shown in Figure 5 .

Figure 5.Total sample physical exercise

Only 18 reported physical exercise out of the total 60 IBS subjects, so to assess the association between them, Chi square test was calculated in Table 3 .

Physical exercise IBS Non-IBS Total
With 18 101 119
With out 42 139 181
Total 60 240 300
Table 3.the associationbetween irritable bowel syndrome and physical exercise

On the contrary of our results, several studies showed a significant association with OR: 1.27, 95% CI: 1.08–1.49, (OR, 6.297).17,18

The recommended Sleeping hours/day is 8hours/day, their percentage among the total sample was shown in Figure 6 .

Figure 6.Sleeping hours in total sample

Only 19 out of the total 60 IBS sufferers sleep enough hours, to assess the association between having enough sleeping hours and IBS chi square was calculated ,Table 4 .

Sleeping hours IBS Non-IBS Total
8 hours 19 73 92
<8 hours 41 167 208
Total 60 240 300
Table 4.sleepinghours and IBS association

Ameta-analysis showed a high prevalence of sleeping disorders among those with IBS..19,20,21

240 students expressed symptoms during stress of examination. Figure 7

Figure 7.lrritable bowel syndrome during stress

Also supported by other studies showing similar results and showing benefits with Psychopharmacological agents.22,23 .

Conclusion:

Prevalence of irritable bowel syndrome was 20% among medical students, which was significantly associated with female sex and stress during examinations while smoking, sport activity &enough sleeping hours showed no association.

References

  1. Lehrer Jenifer K.. MD Irritable Bowel Syndrome Medscape UpdateFeb 06. 2018.
  2. P Thompson W.G., W Heaton K., Morris Manning A. BMJ. 6138; 2:653-654.
  3. VA: Degnon Associates; 2000.
  4. Canavan Joe West, Timothy Card the epidemiology of irritable bowel syndrome Clin. Epidemiol. 2014(6):71-80.
  5. e721.Published online. 2016.
  6. Nahla Khamis Ibrahim A systematic review of the prevalence and risk factors of irritable bowel syndrome among medical students Turk. J Gastroenterol. 2016(27):10-6.
  7. Y. Jeddah, Saudi Arabia Research and Reviews: J Clin Med Case Stud| Volume. 2017.
  8. Adnan Meteb Mohamed Almezani et al. Prevalence of Irritable Bowel Syndrome among Medical Students. Egyptian Journal of Hospital Medicine. 2018; 71(2):2581-2584.
  9. Wissam Abdullatif Alsuwailm et al Irritable Bowel Syndrome among Medical Students and Interns in King Faisal. 2017.
  10. Almutairi et al Prevalence of Irritable Bowel Syndrome and its Associated Factors among Medical Students. International Journal of Medical Research & Health Sciences. 2017:6-2.
  11. et al Sex-Gender Differences in Irritable Bowel Syndrome. Journal of Neurogastroenterology and Motility. 2018(24):544-558.
  12. Rebecca M Lovell, Alexander C Ford Effect of Gender on Prevalence of Irritable Bowel Syndrome in the Community: Systematic Review and Meta-Analysis. The American Journal of Gastroenterology. 7(991-1000)
  13. Diagn Sirri L, Grandi S, Tossani ESmoking in Irritable Bowel Syndrome: A Systematic Review.J Dual. 2017; 3
  14. Laura SirriSmoking in Irritable Bowel Syndrome: A Systematic Review Journal of Dual Diagnosis research and practice in substance abuse comorbidity. Volume. 2017; 13:184-200.
  15. Rajaa Chatila et al Irritable bowel syndrome: prevalence, risk factors in an adult Lebanese population BMC GastroenterologyBMC series – open, inclusive and trusted201717:137https://doi.org/10.1186/s12876-017-0698-2.
  16. Mehdi Sadeghian et al Physical activity in relation to irritable bowel syndrome among Iranian adults. 2018.
  17. Liver Yu-Bin Guo et al Association between Diet and Lifestyle Habits and Irritable Bowel Syndrome: A Case-Control Study Gut. 2015; 9:649-656.
  18. Gastroenterol J.. et al Prevalence of sleep disorder in irritable bowel syndrome: A systematic review with meta-analysis Saudi. 2018.
  19. Ami Patel, et al Effects of Disturbed Sleep on Gastrointestinal and Somatic Pain Symptoms in IBS Aliment Pharmacol Ther. 2016; 44:246-258.
  20. Méndez et al Impact on the Quality of Life of the Association between Sleep Disorders and Irritable Bowel Syndrome ©. 2016.
  21. Motil Prashant Singh et al Psychiatric, Somatic and Other Functional Gastrointestinal Disorders in Patients with Irritable Bowel Syndrome. 2012; 18:324-331.
  22. 2013.

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