Prevalence of Irritable Bowel Syndrome in Medical Students in the Middle East and North Africa

Irritable bowel syndrome (IBS) is a multifactorial chronic disease characterized with functional gastrointestinal disorder which affects the quality of life of the patient. Until now the pathophysiology of IBS was not completely understood but it has been related to multiple mechanisms like: visceral hypersensitivity, Brain-gut axis, post infectious inflammation and genetic abnormalities.(1) Many demographic and environmental factors are considered risk factors for the condition like: sex, age, BMI, social status and life style(2). IBS outspreaded all over the world varying between 14.7% to 16.5% in east Asian countries(3,4). As IBS is diagnosed mainly clinically, many scales have been developed to provide the best sensitivity for diagnosing the condition. The recent common criteria for diagnosing are ROME III and ROME VI. A meta-analysis conducted by Oka et al the pooled prevalence of IBS in 53 surveys that used the Rome III criteria from 38 countries was 9.2% (95% CI 7.6-10.8; I2 = 99.7%). Contrary, the pooled IBS prevalence among the 6 surveys that used the Rome IV criteria from 34 countries was 3.8% (95% CI 3.1-4.5; I2 = 96.6%)(5). The different prevalence rates are probably justified by the multifactorial nature of the disease and the various social status and environments from a country to another. However, there wasn't enough studies could define the prevalence of IBS among middle-eastern countries. The prevalence of IBS varies depending on socioeconomic factors, sex, and age. University students in the Middle East and North Africa are affected by many Lifestyle factors that participate in IBS by one way or another such as unhealthy eating habits (junk or fast food), cigarette smoking, physical inactivity and the fact that they're living low-income countries. IBS has also been associated with psychological factors such as stress, depression, and anxiety. Additionally, as their young age genetic factors and positive family history are implicated. Medical students, are more likely exposed to IBS risk factors as they have limited access to healthy meals, financial constraints, and a excessive exposure to stress secondary to their exceedingly demanding education and frequent examinations. Thus, they are more probably to develop IBS than other population subgroups.