Arnaout Ahmad Y, Nerabani Yaman, Douba Zain, Kassem Luma H, Arnaout Khaled, Shabouk Muhammad B, Zayat Hussein, Mayo Wafik, Bezo Yamen, Arnaout Ibrahim, Yousef Ahmad, Zeina Mohamed B, Aljarad Ziad
Faculty of Medicine University of Aleppo Aleppo Syrian Arab Republic.
Department of Hematology Syrian Arab Republic Ministry of Health Aleppo Syrian Arab Republic.
Health Sci Rep. 2023 Oct 4;6(10):e1592. doi: 10.1002/hsr2.1592. eCollection 2023 Oct.
Because of the plenty and abundance of risk factors and the expected increase in the prevalence of irritable bowel syndrome (IBS) in the world in general and in low- and middle-income countries in particular, this international cross-sectional study was conducted in 15 low- and middle-income countries according to our previous protocol, NCT05340400.
Participants were recruited in the period from April 22, 2022 to June 14, 2022. The diagnosis of IBS was according to ROME IV. We determined the physical activity, daily stress, and fatigue of the participants. A large number of collaborators were chosen from different regions and institutions within each country to achieve diversity within the sample and reduce the probability of bias.
The prevalence of IBS appears to be higher in low- and middle-income countries (mean = 25.2%, range [6.2%-44.2%]) than in high-income countries, with a higher prevalence among Africans than Caucasians and Asians. The prevalence of IBS increased in the fourth decade by 32.1% and in the fifth decade by 31.1% (-value < 0.001). In addition to the previously known risk factors for IBS such as female sex, smoking, psychological stress, and chronic fatigue, other risk factors were discovered such as chronic diseases, including high blood pressure and diabetes, allergies to some substances, previous infection with COVID-19, and the participant having a first-degree relative with a patient. There are also some other modifiable risk factors, such as an abnormal body mass index (whether high or low), smoking, a protein- or fat-rich diet, drinking caffeine-containing beverages, and poor physical activity.
Highlighting the prevalence and increasing risk factors of IBS in developing countries should draw the attention of those responsible for health care in these countries and reduce the risk factors.
由于肠易激综合征（IBS）的风险因素众多且普遍存在，预计全球尤其是低收入和中等收入国家的IBS患病率将会上升，因此，我们按照之前的方案（NCT05340400）在15个低收入和中等收入国家开展了这项国际横断面研究。
研究对象于2022年4月22日至2022年6月14日期间招募。IBS的诊断依据罗马IV标准。我们测定了研究对象的身体活动情况、日常压力和疲劳程度。每个国家都从不同地区和机构挑选了大量合作者，以实现样本的多样性并降低偏差概率。
低收入和中等收入国家的IBS患病率（平均=25.2%，范围[6.2%-44.2%]）似乎高于高收入国家，非洲人的患病率高于白种人和亚洲人。IBS患病率在第四个十年增加了32.1%，在第五个十年增加了31.1%（P值<0.001）。除了先前已知的IBS风险因素，如女性、吸烟、心理压力和慢性疲劳外，还发现了其他风险因素，如慢性疾病，包括高血压和糖尿病、对某些物质过敏、既往感染过新冠病毒以及研究对象有IBS患者的一级亲属。此外，还有一些其他可改变的风险因素，如异常体重指数（无论高低）、吸烟、富含蛋白质或脂肪的饮食、饮用含咖啡因饮料以及身体活动不足。
强调发展中国家IBS的患病率及其不断增加的风险因素应引起这些国家医疗保健负责人的关注，并降低风险因素。
