Irritable bowel syndrome (IBS) is a relapsing functional bowel disorder defined by symptom-based criteria, including recurrent abdominal pain, change of bowel habits, and symptomatic relief after bowel movement. Physicians should pay attention to alarming clinical features and exclude organic diseases before reaching the diagnosis of IBS. It is important to carefully review the stool patterns to determine the predominant bowel symptoms and IBS subtypes so appropriate treatment could be initiated. The chronic and relapsing nature of the disease has a high impact on patient’s quality of life, resulting in frequent hospital visits and consumption of medical resources. The exact pathophysiology is complex and remains elusive, and previous studies suggested IBS to be multifactorial. Management of IBS includes regular exercise, diet control (low FODMAP diet), probiotics, and medical treatments.
The prevalence of IBS has been reported to be high in Taiwan, 22.1% and 17.5% as defined by the Rome II and I criteria, respectively, according to the 2003 survey of a population receiving physical check-ups at a medical center. However, the prevalence of IBS based on a later nation-wide survey in Taiwan during 2005-2008 was 4.4% using the Rome III criteria. The difference may be explained by the stricter criteria of Rome III criteria on the frequency of abdominal symptoms. Recently, we conducted a study to investigate the updated prevalence and clinical characteristics of IBS in the Taiwanese population. From August 2019 to December 2019, we recruited 501 subjects (mean age 50.8 ± 10.5, male 55.1%) receiving health examinations in National Taiwan University Hospital, and found a 6% prevalence of IBS according to the Rome III criteria. Compared with the control group, the IBS group had higher scores on Brief Symptom Rating Scale (BSRS-5) (4.83±3.41 vs. 2.80 ±2.82, p<0.001), suggesting a higher psychosocial stress. There was also a higher prevalence of psychiatric morbidity (10% vs. 2.5%, P=0.020), as defined by the total BSRS-5 scores >=6. The insomnia symptoms base on the Athens Insomnia Scale were also higher in the IBS group (7.35±4.32 vs. 4.39±3.72, p<0.001). The severity of psychiatric and insomnia symptoms was positively correlated with the frequency of abdominal pain. Our study suggests the pivotal role of psychiatric stress and sleep disturbance on the rising prevalence of IBS in Taiwan. |
