Medical Students Have Higher Rates of Irritable Bowel Syndrome

Medical students are more susceptible to irritable bowel syndrome (IBS) and the depression and anxiety symptoms that may be associated with the disease.

A team, led by Sehrish Shafique, Bahria University Medical Dental College (BUMDC), identified the frequency of IBS among medical students and the frequency of common subtypes of IBS among IBS positive medical students.

The investigators also identified the association between psychiatric conditions such as anxiety and depression and irritable bowel syndrome.

In the cross-sectional study, the investigators examined 370 medical students at BUMDC between September and November 2020. Of the 370 participants, 41% (n = 152) students were diagnosed with irritable bowel syndrome in accordance with the ROME 111 criteria.

Each participant answered questionnaires and the total students with IBD were presented by frequencies, with findings analyzed using ROME 111 and the HAD scale.

IBS Subtypes and Psychiatric Symptoms

The investigators identified common IBS subtypes and identified IBS-D (diarrhea) 80 as the most common subtype.

This was also directly related to the mental health symptoms, as anxiety was positive in 100 students and depression was seen in 5 students in accordance with the HAD scale.

“This study concludes that medical students are more prone to develop IBS which is aggravated by stress related anxiety for having extensive curriculum and pressure from the peers of having good score in exam among intellectual section of the society which is not an easy task to cope up,” the authors wrote.

Global Rates of IBS

Last year, investigators found the global prevalence of IBS could be lower based on how stringent a criteria clinicians use.

While IBS represents one of the most common functional bowel disorders, community prevalence can vary widely between different countries. This variation might be explained by previous cross-sectional surveys that neither applied uniform diagnostic criteria nor used identical methodology, rather than being due to true global variability.

In the systematic review and meta-analysis, the investigators identified data from all population-based studies using relatively uniform methodology. These studies used only the most recent iterations of the Rome criteria—Rome III and Rome IV.

Overall, they identified 4143 citations, of which 57 studies were deemed eligible involving 92 separate adult populations totaling 423,362 participants. The pooled disease prevalence of IBS in the 53 studies from 38 countries involving 395,385 participants using the Rome III criteria was 9.2% (95% CI, 7.6-10.8; I²= 99.7%).

On the other hand, the pooled IBS prevalence from 6 studies in 34 countries involving 82,476 individuals using the Rome IV criteria was 3.8% (95% CI, 3.1-4.5; I²= 96.6%).

However, IBS with diarrhea was the most common subtype with the Rome IV criteria (reported by 31.5% [95% CI, 23.2–40.5; I²= 98.1% 61.6%] of people with IBS, corresponding to 1.4% [0.9–1.9] of all included participants having IBS-D).

The investigators also found higher rates of IBS in women than males (12.0% [95% CI, 9.3–15.0] vs 8.6% [6.3–11.2]; OR, 1.46 [95% CI, 1.33–1.59]).

Prevalence also varied significantly between individual countries. This variability persisted even when the same diagnostic criteria was applied and identical methodology was using in studies.

The study, “Irritable bowel syndrome among medical students and its association with anxiety,” was published online in The Professional Medical Journal.