Prevalence of Irritable Bowel Syndrome and Its Association with Anxiety Among Students of Private and Public Medical Colleges
DOI:
https://doi.org/10.52206/jsmc.2025.15.2.1040Abstract
Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by fluctuating bowel habits, abdominal discomfort, and bloating, without anatomical abnormalities. IBS symptoms are often exacerbated by stress.
Objective: To assess the prevalence of Irritable bowel syndrome and investigate its association with anxiety levels among medical students in Khyber Pakhtunkhwa, Pakistan.
Materials and Methods: This analytical cross-sectional study was conducted in medical colleges in Khyber Pakhtunkhwa from May to September 2023. A sample of 270 medical students was selected using non-probability convenience sampling. Inclusion criteria were consenting medical students, while non-medical students and those with insufficient responses were excluded. Data were collected using a structured questionnaire, including the Birmingham questionnaire (based on ROME II criteria) for assessing IBS symptoms and the Generalized Anxiety Disorder 7 Scale for measuring anxiety levels. Data analysis was performed using SPSS version 26, regression and correlation tests were performed to assess the relationship between anxiety levels and IBS prevalence among medical students. Descriptive statistics were used to summarize the data, and results were presented in the form of tables and figures.
Results: A total of 270 students met the inclusion criteria, with 108 (40%) diagnosed with IBS according to ROME II criteria. Females (52.7%) had a higher prevalence of IBS than males (47.2%). Severe anxiety prevalence was 19% according to GAD-7, with 43% of IBS-diagnosed students experiencing severe anxiety. Data analysis revealed a significant association (P< 0.001) between IBS and anxiety symptoms.
Conclusion: IBS is prevalent among medical students, often exacerbated by stress and anxiety from their demanding curriculum. Patients diagnosed with IBS should be screened for anxiety and managed accordingly.
Keywords: Anxiety, Irritable Bowel Syndrome, KPK, Medical Students, Stress.
References
Daniluk J, Malecka-Wojciesko E, Skrzydlo-Radomanska B, Rydzewska G. The efficacy of mebeverine in the treatment of irritable bowel syndrome—A systematic review. J Clin Med. 2022 Feb 17;11(4):1044. https://doi.org/10.3390/jcm11041044
Alzahrani TA, Aljuaid AS, Alharthi TM, Aljabir AS, Aziz LA. The prevalence and risk factors of irritable bowel syndrome among medical students and interns:results of a national survey in Saudia Arabia. Int J Med. 2018; 4(10): 85-89. https://doi.org/10.24911/IJMDC.51-1590064231
Szuhany KL, Simon NM. Anxiety disorders: a review. Jama. 2022 Dec 27;328(24):2431-45. https://doi.org/10.1001/jama.2022.22744
Lupu VV, Ghiciuc CM, Stefanescu G, Mihai CM, Popp A, Sasaran MO. et al Emerging role of the gut microbiome in post-infectious irritable bowel syndrome: A literature review. WJG.2023 Jun 6;29(21):32-41. https://doi.org/10.3748/wjg.v29.i21.3241
Nanda S, Sungono V. Relationship between psychological distress and irritable bowel syndrome (ibs) in medical students of Pelita Harapan University. JGHE. 2020; 21(3): 199-206. https://doi.org/10.24871/2132020199-206
Mahyoub MA, Abbas O, Elhoumed M, Ghabisha S, Refat M, Abbas M, et al. Dietary habits as associated factors with irritable bowel syndrome among medical students: evidence from a cross-sectional study. BMC gastroenterology. 2024 Aug 17;24(1):268. https://doi.org/10.1186/s12876-024-03320-w
Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study. Gastroenterology. 2021 Jan 1;160(1):99-114. https://doi.org/10.1053/j.gastro.2020.04.014
Elhosseiny D, Mahmoud NE, Manzour AF. Factors associated with irritable bowel syndrome among medical students at Ain Shams University. JEPHA. 2019 Dec;94:1-9. https://doi.org/10.1186/s42506-019-0023-8
AlButaysh OF, AlQuraini AA, Almukhaitah AA, Alahmdi YM, Alharbi FS. Epidemiology of irritable bowel syndrome and its associated factors in Saudi undergraduate students. SJG. 2020 Mar 1;26(2):89-93. https://doi.org/10.4103/sjg.SJG_459_19
Khan AR, Khan A, Ahmad F, Abbas Y. Prevalence of irritable bowel syndrome and its association with stress and other risk factors among university students of peshawar. J Med Sci. 2018; 26: (4) 312- 316. https://jmedsci.com/index.php/Jmedsci/article/view/597
Abid S, Rehman H, Awan S, Artani A, Siddiqui I. Epidemiology of functional gastrointestinal disorders using ROME III adult questionnaire, a population based cross sectional study in Karachi—Pakistan. Plos one. 2022 Jun 13;17(6):e0268403. https://doi.org/10.1371/journal.pone.0268403.eCollection2022
Hisam A, Mashhadi SF, Ashfaq M, Javed H, Ahmed H, Waqas M, et al. Prevalence of Anxiety Related Irritable Bowel Syndrome Symptoms Among Medical Students of Rawalpindi. PAFMJ. 2022;72(SUPPL-4):S914-18. https://doi.org/10.51253/pafmj.v72iSUPPL-4.9837
Nawahirsha S. A Study to validate a modified birmingham questionnaire in assessing the symptoms of IBS patients, TEJCM. 2024 Feb 21;14:494-503. https://healthcare-bulletin.co.uk/article/volume-14-issue-2-pages494-503-ra/
Banstola S, Lamichhane S. Prevalence of anxiety among pre-clinical medical students: A cross- sectional study. JGMCN. 2024 Jun 20;17(1):68-72. https://doi.org/10.3126/jgmcn.v17i1.65583
Gallas S, Knaz H, Methnani J, Kanzali MM, Koukane A, Bedoui MH, et al. Prevalence and risk factors of functional gastrointestinal disorders in early period medical students: a pilot study in Tunisia. LJM. 2022 Oct 14;17(1). https://doi.org/10.1080/19932820.2022.2082029
Ahmed SA, Alotaibi YM, Alayed SI, Al Alshaykh OM, Alothman OM, Alhumaidi AA. Prevalence of irritable bowel syndrome among medical students in Imam Mohammad Ibn Saud Islamic University. IJMDC. 2020 May 16;4(5):896-. https://doi.org/10.24911/IJMDC.51-1585049765
Dabbagh R, Alwatban L, Alrubaiaan M, Alharbi S, Aldahkil S, AlMuteb M, et al. Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review. MT. 2023 May 4;45(5):499-509. https://doi.org/10.1080/0142159X.2022.2139669
El Sharawy SM, Amer IF, Elkadeem MZ. Irritable bowel syndrome in Egyptian medical students, prevalence and associated factors: a cross-sectional study. PAMJ. 2022 Apr 18;41(1). https://doi.org/10.11604/pamj.2022.41.311.28228
Alshaikh AA, Alamri SM, Riaz F, Mahmood SE, Shlwan MA, Almuidh FN, et al. Exploring the burden of irritable bowel syndrome among university students in Saudi Arabia: A study on prevalence, psychological associations, and well-being. Medicine. 2024 May 10;103(19):e38099. https://doi.org/10.1097/MD.0000000000038099
Shafique S, Faraz N, Wasti H, Surti A. Irritable bowel syndrome among medical students and its association with anxiety. TPMJ. 2021:28(11), 1561-1565. https://doi.org/10.29309/TPMJ/2021.28.11.6326
Jemilohun A, Abayomi O, Adebayo P. Prevalence of irritable bowel syndrome, psychological ill-health and health-seeking behavior in a population of Nigerian medical students. JAMMR. 2018;25(4):1- 9. https://doi.org/10.9734/JAMMR/2018/39235
Jadallah KA, Khatatbeh MM, Sarsak EW, Sweidan AN, Alzubi BF. Irritable bowel syndrome and its associated factors among Jordanian medical students: A cross-sectional study. Medicine. 2022 Aug 19;101(33):e30134. https://doi.org/10.1097/MD.0000000000030134
Quiroga-Castañeda PP, Berrios-Villegas I, Valladares-Garrido D, Vera-Ponce VJ, Zila-Velasque JP, Pereira-Victorio CJ, et al. Irritable Bowel Syndrome in medical students at a Peruvian university: a cross-sectional study. FM. 2024 Apr 5;11:1341809. https://doi.org/10.3389/fmed.2024.1341809
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