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Cited by 884Gastrointestinal motility and disordersInfant Health and DevelopmentGut microbiota and health

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Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis

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Oka, Priya, Parr, Heather, Barberio, Brigida, Black, Christopher J, Savarino, Edoardo V, Ford, Alexander C·2020·The Lancet Gastroenterology & Hepatology
DOI 10.1016/s2468-1253(20)30217-x
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Abstract

Background Irritable bowel syndrome (IBS) is one of the most common functional bowel disorders, but community prevalence appears to vary widely between different countries. This variation might be due to the fact that previous cross-sectional surveys have neither applied uniform diagnostic criteria nor used identical methodology, rather than being due to true global variability. We aimed to determine the global prevalence of IBS.Methods We did a systematic review and meta-analysis of data from all population-based studies using relatively uniform methodology and using only the most recent iterations of the Rome criteria (Rome III and IV). We searched MEDLINE, Embase, and Embase Classic (from Jan 1, 2006, to April 30, 2020) to identify cross-sectional surveys reporting the prevalence of IBS in adults (≥90% of participants aged ≥18 years) according to the Rome III or Rome IV criteria. We also hand-searched a selection of conference proceedings for relevant abstracts published between 2006 and 2019. We extracted prevalence data for all studies, according to the criteria used to define the presence of IBS. We did a meta-analysis to estimate pooled prevalence rates, according to study location and certain other characteristics (eg, sex and IBS subtype).Findings We identified 4143 citations, of which 184 studies appeared relevant. 57 of these studies were eligible, and represented 92 separate adult populations, comprising 423 362 participants. The pooled prevalence of IBS in 53 studies that used the Rome III criteria, from 38 countries and comprising 395 385 participants, was 9·2% (95% CI 7·6-10·8; I 2=99·7%). By contrast, pooled IBS prevalence among six studies that used the Rome IV criteria, from 34 countries and comprising 82 476 individuals, was 3·8% (95% CI 3·1-4·5; I 2=96·6%). IBS with mixed bowel habit (IBS-M) was the most common subtype with the Rome III criteria, reported by 33·8% (95% CI 27·8-40·0; I 2=98·1%) of people fulfilling criteria for IBS (ie, 3·7% [2·6-4·9] of all included participants had IBS-M), but IBS with diarrhoea (IBS-D) was the most common subtype with the Rome IV criteria (reported by 31·5% [95% CI 23·2-40·5; I 2=98·1% 61·6%] of people with IBS, corresponding to 1·4% [0·9-1·9] of all included participants having IBS-D). The prevalence of IBS was higher in women than in men (12·0% [95% CI 9·3-15·0] vs 8·6% [6·3-11·2]; odds ratio 1·46 [95% CI 1·33-1·59]). Prevalence varied substantially between individual countries, and this variability persisted even when the same diagnostic criteria were applied and identical methodology was used in studies.Interpretation Even when uniform symptom-based criteria are applied, based on identical methodology, to define the presence of IBS, prevalence varies substantially between countries. Prevalence was substantially lower with the Rome IV criteria, suggesting that these more restrictive criteria might be less suitable than Rome III for population-based epidemiological surveys.Funding None.

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Research works printed but not linked: 5

  1. Gómez Alvarez, 2009, Prevalence of irritable bowel syndrome and associated factors according to the Rome III diagnostic criteria in a general population in Colombia, Gastroenterol Hepatol, 32, 395
  2. Raiza, 2012, Fernando Cubas Benavides CDV. Prevalence of irritable bowel syndrome in the adult population of the City of Chiclayo in 2011, Rev Gastroenterol Peru, 32, 381
  3. Zito, 2015, Mediterranean diet adherence may influence functional gastrointestinal symptoms, Dig Liver Dis, 47, e173
  4. Kumar Ghosh, 2016, Prevalence of irritable bowel syndrome: a comparison between rural and urban setting in Bangladesh, J Gastroenterol Hepatol, 31, 159
  5. Rao, 2019, Study of consumption of spicy foods and the prevalence of irritable bowel syndrome in Darbhanga district, Bihar, India, Gut, 68, A26

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Metadata

Authors
Oka, P., Parr, H., Barberio, B., Black, C. J., Savarino, E. V., & Ford, A. C.
Affiliations
  • University of Leeds (GB)
  • University of Padua (IT)
Corresponding author
Ford, Alexander C
ORCID
Venue
The Lancet Gastroenterology & Hepatology
Publisher
Elsevier BV
Published
2020-10
Volume
5
Issue
10
Pages
908-917
ISSN
  • 2468-1156 (ISSN-L)
  • 2468-1253
DOI
10.1016/s2468-1253(20)30217-x
OpenAlex
W3042758557
Cited by
882
References
88
Citations by year
2026: 148 · 2025: 158 · 2024: 199 · 2023: 152 · 2022: 128 · 2021: 83 · 2020: 11
FWCI
16.35
Type
journal article
Language
en
Update notices
erratum (2020-12-01)
Open access
Licence
Locations
  • The Lancet. Gastroenterology & hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
irritable bowel syndrome, prevalence, Rome III criteria, Rome IV criteria, functional bowel disorders, IBS subtypes, irritable bowel syndrome with constipation, diagnostic criteria, adults, sex differences, cross-cultural comparison, population survey
MeSH terms
Adult, Cross-Sectional Studies, Defecation, Diarrhea, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Prevalence, Irritable Bowel Syndrome

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