Prevalence of IBS using Rome IV criteria higher than previously estimated, survey shows
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Key takeaways:
- Prevalence of Rome IV irritable bowel syndrome was 6.1% in the U.S., according to a large-scale study.
- The most commonly reported concomitant symptoms were bloating, excess gas, heartburn and nausea/vomiting.
A nationwide survey of nearly 89,000 individuals estimated the prevalence of Rome IV irritable bowel syndrome in the U.S. to be 6.1% compared with 4.7% to 5.3% in previous reports, according to a cross-sectional study in Gastroenterology.
“Prior studies in the U.S. that estimated the prevalence of IBS were based on samples sizes of around 2,000 people,” Christopher V. Almario, MD, MSHPM, assistant professor of medicine in the division of gastroenterology and hepatology at Cedars-Sinai Medical Center, told Healio. “We conducted a nationwide GI survey with nearly 89,000 people to update our understanding on how common IBS is in the U.S., as well as its associated burden of illness.”
Researchers conducted a nationwide, online survey in early 2020 to assess the prevalence of IBS using Rome IV criteria as well as determine severity of symptoms and health care-seeking behaviors.
Among 88,607 respondents, 5,414 (6.1%) met Rome IV IBS criteria, of whom 33.9% had mixed IBS (IBS-M), 33.6% IBS-constipation, 28.1% IBS-diarrhea and 4.4% unsubtyped IBS (IBS-U). Women had higher odds for IBS, while individuals older than 60 years had lower odds compared with those aged 18 to 29 years.
“We also looked at racial and ethnic differences in IBS prevalence and observed that non-Hispanic Blacks, Hispanics and non-Hispanic Asians all were less likely to have IBS when compared to non-Hispanic whites,” Almario added.
Several comorbidities, including prior gastroenteritis, fibromyalgia, gallstones, peptic ulcer disease and thyroid disorder, also increased odds for IBS.
Bloating was one of the most common concomitant symptoms reported in the past 7 days by 56.3% of those with IBS-M, 52.4% of those with IBS-C and 45.4% of those with IBS-D. Other symptoms included excess gas (57%, 50% and 51.2%, respectively), heartburn (48.3%, 43.8% and 46.6%) and nausea or vomiting (30.3%, 22.3% and 26%).
Across these three subtypes, 68.2% to 73.2% reported ever seeking care for their IBS symptoms, with 53.8% to 58.9% doing so in the past 12 months.
Further, 26.2% to 31.5% of people reported managing their symptoms with over-the-counter or nonmedical treatments, while 24.4% to 28.3% reported their symptoms were not bothersome enough to seek medical care and 21.3% to 26.5% reported their symptoms resolved on their own.
Notably, 17.8% to 20.4% of respondents reported they did not feel comfortable discussing their symptoms with a health care provider.
“As patients with IBS experience many other symptoms in addition to belly pain and bowel habit changes, it is important for clinicians to take a thorough history to identify and manage these treatable symptoms,” Almario said. “Additional research is needed to determine if the higher IBS prevalence we observed is in part due to the COVID-19 pandemic during which this study was conducted. Continued research examining why there are racial and ethnic differences in IBS prevalence is also warranted.”
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