Meta-Analysis of Global Prevalence and Gender Distribution of Irritable Bowel Syndrome (IBS) Using Rome III and IV Criteria

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: Estimating the prevalence of irritable bowel syndrome (IBS) is essential to understand its impact. Variations in data arise from different studies, regions, methods, and diagnostic criteria. This systematic review and meta-analysis used the latest Rome III and IV criteria to determine the global prevalence and gender distribution of IBS. Methods: We searched PubMed, Cochrane Library, and Google Scholar till June 1, 2024. Original studies reporting prevalence data on individuals ≥18 years either by Rome III or IV criteria were considered with the exclusion of academic surveys. Prevalence was the main outcome of interest, stratified by subtype, gender, country, and evaluation criteria. To assess the overall prevalence in each category, the Rome IV criterion was preferred. Open Meta-analyst and Review Manager were used for analysis. Prevalence was analyzed by DerSimonian-Laird random-effects model and gender distribution was analyzed by 2-arm analysis. Results: A total of 1435 full-text articles were retrieved and 96 remained after exclusion. The overall prevalence was 14% (12.1-16%) when accounted for study weight. When subtyped, mixed type (IBS-M) had the highest prevalence rate of 33.1% [25.7-40.5%] followed by diarrhea type (IBS-D) (28% [24.2-31.9%]), constipation type (IBS-C) (27.9% [15.6-40.1%]), and unsubtyped (IBS-U) (8.3% [6.3-10.6%]). In a nation-wise breakdown, the UK (36459 events) followed by Japan (13439 events) had the highest prevalence. Women were found to have a higher rate of IBS compared to men (OR 1.49, 95% CI [1.24-1.79]), P < 0.00001). Conclusion: We analyzed the highest prevalence data reported to date for IBS in =1 different countries from 96 studies. The overall prevalence was 14%, higher than previous reports (11.2%). Prevalence was higher with Rome IV criterion despite its restrictiveness, contrary to previous findings. IBS-M had a higher prevalence than IBS-D and IBS-C, but with Rome IV criterion, IBS-C was more prevalent than IBS-D. The UK had the highest IBS rate at 67.5% of global cases, attributed to data from the UK Biobank. IBS was modestly more common in women. Study heterogeneity was due to varying influences like education, culture, environment, ethnicity, and diet. More studies are needed on IBS-U prevalence and using validated questionnaires for Rome III/IV criteria. IBS management costs about ≥1 billion/year, highlighting the need for more trials on curative drugs and their cost-effectiveness, especially for the IBS-M subtype (see Figure 1, Table 1).

Volume

119

Issue

10

First Page

S517

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