Irritable Bowel Syndrome (IBS) Among Jordanian Adults: Uncovering the Underdiagnosed and The Triggering Factors

Derar Abdel-Qader

doi:10.55489/njcm.150220243630

Authors

Derar Abdel-Qader Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan

DOI:

https://doi.org/10.55489/njcm.150220243630

Keywords:

IBS, Rome IV, Factors, Jordan

Abstract

Background: There is no pervious investigation of the prevalence and triggering factors of undiagnosed IBS among Jordanian adults. This study aimed to determine the prevalence of Jordanians living with undiagnosed IBS and examine how sociodemographic variables and symptoms, influenced people with IBS on a daily basis.

Methods: Between July and September 2023, a cross-sectional survey was carried out in Jordan employing proportionate random sampling across the country's regions.

Results: The odds of having IBS were 1.471 and 1.475 times higher in adults with psychological distress and insomnia severity respectively compared with no IBS adults. However, the odds of having IBS were 0.548 and 0.601 times lower in caffeine drinkers and smokers respectively compared to non-IBS. In smokers having IBS, the odds of disordered eating attitudes were significantly greater by 17% compared with nonsmokers having IBS, whereas the BMI was significantly lower by 65.4% compared with nonsmokers having IBS. In comparison to non-caffeine drinking having IBS, the odds of disordered eating attitudes and insomnia severity were significantly greater by 33% and 19.5%, respectively.

Conclusion: The study emphasized the need for increasing IBS awareness among Jordanian citizens to encourage early diagnosis and reduce the proportion of undiagnosed IBS people.

References

Moleski, S. M. Irritable bowel Syndrome (IBS). MSD Manual Professional Edition. 2023, August 10. Available from: https://www.msdmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs

Doshi JA, Cai Q, Buono JL, Spalding WM, Sarocco P, Tan H, Ste-phenson JJ, Carson RT. Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population. Jour-nal of Managed Care Pharmacy. 2014 Apr;20(4):382-90. Doi: https://doi.org/10.18553/jmcp.2014.20.4.382 PMid:24684643 PMCid:PMC10437385

Yazbeck G, Malaeb D, Shaaban H, Sarray El Dine A, Hallit S, Hal-lit R. Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors. BMC Public Health. 2023 Aug 22;23(1):1589. Doi: https://doi.org/10.1186/s12889-023-16543-5 PMid:37605160 PMCid:PMC10463955

Andrews, E. B., Eaton, S. C., Hollis, K. A., Hopkins, J. S., Ameen, V., Hamm et al. Prevalence and demographics of irritable bowel syndrome: results from a large web‐based survey. Al-imentary pharmacology & therapeutics. 2005: 22(10), 935-942. Doi: https://doi.org/10.1111/j.1365-2036.2005.02671.x PMid:16268967

Shah E, Rezaie A, Riddle M, Pimentel M. Psychological disor-ders in gastrointestinal disease: epiphenomenon, cause or consequence? Annals of Gastroenterology: Quarterly Publi-cation of the Hellenic Society of Gastroenterology. 2014; 27(3): 224.

Nojkov B, Rubenstein JH, Chey WD, Hoogerwerf WA. The im-pact of rotating shift work on the prevalence of irritable bowel syndrome in nurses. Am J Gastroenterol. 2014; 105: 842-7. Doi: https://doi.org/10.1038/ajg.2010.48 PMid:20160712 PMCid:PMC2887235

Plavsic I, Hauser G, Tkalcic M, Pletikosic S, Salkic N. Diagnosis of irritable bowel syndrome: role of potential biomarkers. Gastroenterol Res Pract. 2015; 490183.

Henstrom M, D'Amato M. Genetics of irritable bowel syn-drome. Mol Cell Pediatric. 2016; 3: 7. Doi: https://doi.org/10.1186/s40348-016-0038-6 PMid:26873717 PMCid:PMC4752571

Lucak S, Chang L, Halpert A, and Harris LA. Current and emer-gent pharmacologic treatments for irritable bowel syndrome with diarrhea: evidence-based treatment in practice. Ther Adv Gastroenter. 2016; Page 7/8 10: 253-275. Doi: https://doi.org/10.1177/1756283X16663396 PMid:28203283 PMCid:PMC5298476

Lacy BE, Patel NK. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017; 6: e99. Doi: https://doi.org/10.3390/jcm6110099 PMid:29072609 PMCid:PMC5704116

Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clinical epidemiology. 2014 Feb 4:71-80. Doi: https://doi.org/10.2147/CLEP.S40245 PMid:24523597 PMCid:PMC3921083

Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenter-ol Hepatol. 2012;10(7):712-7214. e4. Doi: https://doi.org/10.1016/j.cgh.2012.02.029 PMid:22426087

Quach DT, Vu KT, Vu KV. Prevalence, clinical characteristics, and management of irritable bowel syndrome in Vietnam: A scoping review. JGH Open. 2021 Nov;5(11):1227-35. Doi: https://doi.org/10.1002/jgh3.12616 PMid:34816008 PMCid:PMC8593809

Al-Shdaifat A, Al-Kassar A, Johannessen A, Al-Dabbagh Z, Al-Ethawi M, Al-Obaidi F, El-Halabi I. Irritable Bowel Syndrome Among University Students in Jordan, 2019. Doi: https://doi.org/10.21203/rs.2.11508/v1

Guthrie E, Creed F, Fernandes L, Ratcliffe J, Van Der Jagt J, Mar-tin J, Howlett S, Read N, Barlow J, Thompson D, Tomenson B. Cluster analysis of symptoms and health seeking behaviour differentiates subgroups of patients with severe irritable bowel syndrome. Gut. 2003 Nov;52(11):1616. Doi: https://doi.org/10.1136/gut.52.11.1616 PMid:14570732 PMCid:PMC1773851

Lee SK, Yoon DW, Lee S, Kim J, Choi KM, Shin C. The association between irritable bowel syndrome and the coexistence of de-pression and insomnia. Journal of Psychosomatic Research. 2017 Feb 1;93:1-5. Doi: https://doi.org/10.1016/j.jpsychores.2016.12.007 PMid:28107884

Al-Shdaifat A, Al-Kassar A, Johannessen A, Al-Dabbagh Z, Al-Ethawi M, Al-Obaidi F, El-Halabi I. Irritable Bowel Syndrome Among University Students in Jordan. 2019. Doi: https://doi.org/10.21203/rs.2.11508/v1

Black, C. J., Drossman, D. A., Talley, N. J., Ruddy, J., & Ford, A. C. Functional gastrointestinal disorders: advances in under-standing and management. The Lancet. 2020: 396(10263), 1664-1674. Doi: https://doi.org/10.1016/S0140-6736(20)32115-2 PMid:33049221

Saadi, T. A., Idris, A., Turk, T., & Al‐Khatib, M. A. Epidemiology and risk factors of uninvestigated dyspepsia, irritable bowel syndrome, and gastroesophageal reflux disease among stu-dents of Damascus University, Syria. Journal of Epidemiology and Global Health. 2016: 6(4), 285. Doi: https://doi.org/10.1016/j.jegh.2016.07.001 PMid:27501053 PMCid:PMC7320468

Chang, F. Y., & Lu, C. L. Irritable bowel syndrome in the 21st century: Perspectives from Asia or South-east Asia. Journal of Gastroenterology and Hepatology. 2007: 22(1), 4-12. Doi: https://doi.org/10.1111/j.1440-1746.2006.04672.x PMid:17201873

Department of Statistics. Annual report. 2023. Available from: https://dosweb.dos.gov.jo/DataBank/Population/Population_Estimares/PopulationEstimates.pdf.

Palsson OS, Whitehead WE, van Tilburg MA, Chang L, Chey W, Crowell MD, et al. (2016). Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians. Gastroenterolo-gy. 2016: S0016-5085(16)00180-3. Doi: https://doi.org/10.1053/j. gastro.2016.02.014.3

Ali, A. M., Alkhamees, A. A., Hori, H., Kim, Y., & Kunugi, H. The depression anxiety stress scale 21: development and valida-tion of the depression anxiety stress scale 8-item in psychiat-ric patients and the general public for easier mental health measurement in a post COVID-19 world. International Jour-nal of Environmental Research and Public Health, 2021:18(19), 10142. Doi: https://doi.org/10.3390/ijerph181910142 PMid:34639443 PMCid:PMC8507889

Ali, A. M., Hori, H., Kim, Y., & Kunugi, H. The Depression Anxie-ty Stress Scale 8-items expresses robust psychometric prop-erties as an ideal shorter version of the Depression Anxiety Stress Scale 21 among healthy respondents from three conti-nents. Frontiers in psychology, 2022:13, 799769. Doi: https://doi.org/10.3389/fpsyg.2022.799769 PMid:35496141 PMCid:PMC9044488

Hallit, S., Haddad, C., Hallit, R., Al Karaki, G., Malaeb, D., Sacre, H., ... & Salameh, P. Validation of selected sleeping disorders related scales in Arabic among the Lebanese population. Sleep and Biological Rhythms, 2019:17, 183-189. Doi: https://doi.org/10.1007/s41105-018-0196-0

Fekih-Romdhane, F., Obeid, S., Malaeb, D., Hallit, R., & Hallit, S. Validation of a shortened version of the Eating Attitude Test (EAT-7) in the Arabic language. Journal of eating disorders. 2022: 10(1), 1-8. Doi: https://doi.org/10.1186/s40337-022-00651-5 PMid:36028891 PMCid:PMC9412802

Mahmood, K., Riaz, R., Haq, M. S. U., Hamid, K., & Jawed, H. As-sociation of cigarette smoking with irritable bowel syn-drome: A cross-sectional study. The Medical Journal of the Is-lamic Republic of Iran. 2020: 34(1), 510-516. https://doi.org/ 10.34171/mjiri.34.72. Doi: https://doi.org/10.47176/mjiri.34.72 PMid:33306053 PMCid:PMC7711034

Koochakpoor, G., Salari-Moghaddam, A., Keshteli, A. H., Es-maillzadeh, A., & Adibi, P. Association of coffee and caffeine in-take with irritable bowel syndrome in adults. Frontiers in Nutrition. 2021: 8. Doi: https://doi.org/10.3389/fnut.2021.632469 PMid:34211993 PMCid:PMC8241212

Jadallah, K., Khatatbeh, M., Sarsak, E. W., Sweidan, A. N., & Alzubi, B. F. Irritable bowel syndrome and its associated fac-tors among Jordanian medical students: A cross-sectional study. Medicine, 2022: 101(33), e30134. Doi: https://doi.org/10.1097/MD.0000000000030134 PMid:35984126 PMCid:PMC9387975

Palsson, O. S., Whitehead, W., Törnblom, H., Sperber, A. D., & Simren, M. Prevalence of Rome IV functional bowel disorders among adults i n the United States, Canada, and the United Kingdom. Gastroenterology, 2020: 158(5), 1262-1273. Doi: https://doi.org/10.1053/j.gastro.2019.12.021 PMid:31917991

Lovell, R. M., & Ford, A. C. Global prevalence of and risk fac-tors for irritable bowel syndrome: a meta-analysis. Clinical gastroenterology and hepatology, 2012: 10(7), 712-721. Doi: https://doi.org/10.1016/j.cgh.2012.02.029 PMid:22426087

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 syn-drome: a case control study. Annals of medical and health sci-ences research, 2013: 3(3), 391-396. Doi: https://doi.org/10.4103/2141-9248.117958 PMid:24116320 PMCid:PMC3793446

Iftikhar, B., & Naveed, H. Prevalence of Irritable Bowel Syn-drome and it's Risk Factors Among Medical Students of Pesh-awar, Pakistan. Pakistan Journal of Medical Research, 2018: 57(1).

Ibrahim, N., Al-Jamhoor, S., Ashor, N., Alsulami, A., Bukhari, D., Al-Bloshi, A., & Fathi, T. Irritable bowel syndrome among paramedical students, King Abdulaziz University, Jeddah, Saudi Arabia. Journal of Advances in Medicine and Medical Re-search, 2018: 25(6), 1-9. Doi: https://doi.org/10.9734/JAMMR/2018/39233

Sadiq, M., & Salih, A. A. The prevalence of irritable bowel syn-drome and associated factors among a sample of medical col-lege students in Baghdad. J Med Case Rep Rev. 2019: 2, 133-6.

Jemilohun, A., Abayomi, O., & Adebayo, P. Prevalence of irrita-ble bowel syndrome, psychological ill-health and health-seeking behavior in a population of Nigerian medical stu-dents. Journal of Advances in Medicine and Medical Research. 2018: 25(4), 1-9. Doi: https://doi.org/10.9734/JAMMR/2018/39235

Oka, P., Parr, H., Barberio, B., Black, C. J., Savarino, E. V., & Ford, A. C. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. The lancet Gastroenterology & hepatology. 2020: 5(10), 908-917. Doi: https://doi.org/10.1016/S2468-1253(20)30217-X PMid:32702295

Wani, F. A., Almaeen, A. H., Bandy, A. H., Thirunavukkarsu, A., Al-Sayer, T. A., Flah, A., ... & Albalawi, M. M. Prevalence and risk factors of IBS among medical and nonmedical students in the Jouf University. Nigerian Journal of Clinical Practice. 2020: 23(4), 555-560. Doi: https://doi.org/10.4103/njcp.njcp_512_18 PMid:32246665

Kim, Y. J., & Ban, D. J. Prevalence of irritable bowel syndrome, influence of lifestyle factors and bowel habits in Korean col-lege students. International journal of nursing studies. 2005: 42(3), 247-254. Doi: https://doi.org/10.1016/j.ijnurstu.2004.06.015 PMid:15708012

Ibrahim, N. K. R., Battarjee, W. F., & Almehmadi, S. A. Preva-lence and predictors of irritable bowel syndrome among medical students and interns in King Abdulaziz University, Jeddah. Libyan Journal of Medicine. 2013: 8(1). Doi: https://doi.org/10.3402/ljm.v8i0.21287 PMid:24054184 PMCid:PMC3779356

Johannesson, E., Ringström, G., Abrahamsson, H., & Sadik, R. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World journal of gastroenterology: WJG. 2015: 21(2), 600. Doi: https://doi.org/10.3748/wjg.v21.i2.600 PMid:25593485 PMCid:PMC4294172

Sadeghian, M., Sadeghi, O., Hassanzadeh Keshteli, A., Daghaghzadeh, H., Esmaillzadeh, A., & Adibi, P. Physical activi-ty in relation to irritable bowel syndrome among Iranian adults. PloS one. 2018: 13(10), e0205806. Doi: https://doi.org/10.1371/journal.pone.0205806 PMid:30335859 PMCid:PMC6193664

AlButaysh, O. F., AlQuraini, A. A., Almukhaitah, A. A., Alahmdi, Y. M., & Alharbi, F. S. Epidemiology of irritable bowel syn-drome and its associated factors in Saudi undergraduate stu-dents. Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association. 2020: 26(2), 89. Doi: https://doi.org/10.4103/sjg.SJG_459_19 PMid:32031159 PMCid:PMC7279070

Wang, B., Duan, R., & Duan, L. Prevalence of sleep disorder in irritable bowel syndrome: a systematic review with meta-analysis. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association. 2018: 24(3), 141. Doi: https://doi.org/10.4103/sjg.SJG_603_17 PMid:29652034 PMCid:PMC5985632

Grover, M., Kolla, B. P., Pamarthy, R., Mansukhani, M. P., Breen-Lyles, M., He, J. P., & Merikangas, K. R. Psychological, physical, and sleep comorbidities and functional impairment in irrita-ble bowel syndrome: Results from a national survey of US adults. PloS one. 2021: 16(1), e0245323. Doi: https://doi.org/10.1371/journal.pone.0245323 PMid:33444383 PMCid:PMC7808669

Balikji, S., Mackus, M., Brookhuis, K. A., Garssen, J., Kraneveld, A. D., Roth, T., & Verster, J. C. The association of insomnia, per-ceived immune functioning, and irritable bowel syndrome complaints. Journal of clinical medicine. 2018: 7(9), 238. Doi: https://doi.org/10.3390/jcm7090238 PMid:30149521 PMCid:PMC6162819

Zamani, M., Alizadeh‐Tabari, S., & Zamani, V. Systematic re-view with meta‐analysis: the prevalence of anxiety and de-pression in patients with irritable bowel syndrome. Alimen-tary pharmacology & therapeutics. 2019: 50(2), 132-143. Doi: https://doi.org/10.1111/apt.15325 PMid:31157418

Yeh, H. W., Chien, W. C., Chung, C. H., Hu, J. M., & Tzeng, N. S. Risk of psychiatric disorders in irritable bowel syndrome-A nationwide, population‐based, cohort study. International journal of clinical practice. 2018: 72(7), e13212. Doi: https://doi.org/10.1111/ijcp.13212 PMid:29920876

Zhang, Q. E., Wang, F., Qin, G., Zheng, W., Ng, C. H., Ungvari, G. S., ... & Xiang, Y. T. Depressive symptoms in patients with irrita-ble bowel syndrome: a meta-analysis of comparative studies. International Journal of Biological Sciences. 2018: 14(11), 1504. Doi: https://doi.org/10.7150/ijbs.25001 PMid:30263003 PMCid:PMC6158731

Shen, L., Kong, H., & Hou, X. Prevalence of irritable bowel syn-drome and its relationship with psychological stress status in Chinese university students. Journal of gastroenterology and hepatology. 2009: 24(12), 1885-1890. Doi: https://doi.org/10.1111/j.1440-1746.2009.05943.x PMid:19780881

Sibelli, A., Chalder, T., Everitt, H., Workman, P., Windgassen, S., & Moss-Morris, R. A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syn-drome onset. Psychological medicine. 2016: 46(15), 3065-3080. Doi: https://doi.org/10.1017/S0033291716001987 PMid:27605134

Simrén, M., Månsson, A., Langkilde, A. M., Svedlund, J., Abra-hamsson, H., Bengtsson, U., & Björnsson, E. S. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001: 63(2), 108-115. Doi: https://doi.org/10.1159/000051878 PMid:11244249

Reed‐Knight, B., Squires, M., Chitkara, D. K., & van Tilburg, M. A. Adolescents with irritable bowel syndrome report in-creased eating‐associated symptoms, changes in dietary composition, and altered eating behaviors: a pilot compari-son study to healthy adolescents. Neurogastroenterology & Motility. 2016: 28(12), 1915-1920. Doi: https://doi.org/10.1111/nmo.12894 PMid:27353222 PMCid:PMC5125908

Solmi, M., Veronese, N., Sergi, G., Luchini, C., Favaro, A., San-tonastaso, P., ... & Stubbs, B. The association between smoking prevalence and eating disorders: A systematic review and meta‐analysis. Addiction. 2016: 111(11), 1914-1922. Doi: https://doi.org/10.1111/add.13457 PMid:27206671

Fairweather‐Schmidt, K., & Wade, T. D. The relationship be-tween disordered eating and cigarette smoking among adult female twins. International Journal of Eating Disorders. 2015: 48(6), 708-714. Doi: https://doi.org/10.1002/eat.22363 PMid:25363425

Aasbrenn, M., Lydersen, S., & Farup, P. G. A conservative weight loss intervention relieves bowel symptoms in morbidly obese subjects with irritable bowel syndrome: a pro-spective cohort study. Journal of obesity. 2018. Doi: https://doi.org/10.1155/2018/3732753 PMid:29686892 PMCid:PMC5852871

Wang, C., & Fang, X. Inflammation and overlap of irritable bowel syndrome and functional dyspepsia. Journal of Neuro-gastroenterology and Motility. 2021: 27(2), 153. Doi: https://doi.org/10.5056/jnm20175 PMid:33795538 PMCid:PMC8026374

Thomas-Dupont, P., Velázquez-Soto, H., Izaguirre-Hernández, I. Y., Amieva-Balmori, M., Triana-Romero, A., Islas-Vázquez, L., ... & Remes-Troche, J. M. Obesity Contributes to Inflammation in Patients with IBS via Complement Component 3 and C-Reactive Protein. Nutrients. 2022: 14(24), 5227. Doi: https://doi.org/10.3390/nu14245227 PMid:36558394 PMCid:PMC9781895

Wang, H., Zhao, J. X., Hu, N., Ren, J., Du, M., & Zhu, M. J. Side-stream smoking reduces intestinal inflammation and increases expression of tight junction proteins. World journal of gas-troenterology: WJG. 2012: 18(18), 2180. Doi: https://doi.org/10.3748/wjg.v18.i18.2180 PMid:22611310 PMCid:PMC3351767

Koochakpoor, G., Salari-Moghaddam, A., Keshteli, A. H., Esmaillzadeh, A., & Adibi, P. Association of coffee and caffeine in-take with irritable bowel syndrome in adults. Frontiers in Nutrition. 2021: 8, 632469. Doi: https://doi.org/10.3389/fnut.2021.632469 PMid:34211993 PMCid:PMC8241212

Patel, A., Hasak, S., Cassell, B., Ciorba, M. A., Vivio, E. E., Kumar, M., ... & Sayuk, G. S. Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome. Alimentary pharmacology & therapeutics. 2016: 44(3), 246-258. Doi: https://doi.org/10.1111/apt.13677 PMid:27240555 PMCid:PMC5020700

Heizer, W. D., Southern, S., & McGovern, S. The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. Journal of the American dietetic association. 2009: 109(7), 1204-1214. Doi: https://doi.org/10.1016/j.jada.2009.04.012 PMid:19559137