Original article
Systematic review and meta-analyses
Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis

https://doi.org/10.1016/j.cgh.2012.02.029Get rights and content

Background & Aims

Many cross-sectional surveys have reported the prevalence of irritable bowel syndrome (IBS), but there have been no recent systematic review of data from all studies to determine its global prevalence and risk factors.

Methods

MEDLINE, EMBASE, and EMBASE Classic were searched (until October 2011) to identify population-based studies that reported the prevalence of IBS in adults (≥15 years old); IBS was defined by using specific symptom-based criteria or questionnaires. The prevalence of IBS was extracted for all studies and based on the criteria used to define it. Pooled prevalence, according to study location and certain other characteristics, odds ratios (ORs), and 95% confidence intervals (CIs) were calculated.

Results

Of the 390 citations evaluated, 81 reported the prevalence of IBS in 80 separate study populations containing 260,960 subjects. Pooled prevalence in all studies was 11.2% (95% CI, 9.8%–12.8%). The prevalence varied according to country (from 1.1% to 45.0%) and criteria used to define IBS. The greatest prevalence values were calculated when ≥3 Manning criteria were used (14%; 95% CI, 10.0%–17.0%); by using the Rome I and Rome II criteria, prevalence values were 8.8% (95% CI, 6.8%–11.2%) and 9.4% (95% CI, 7.8%–11.1%), respectively. The prevalence was higher for women than men (OR, 1.67; 95% CI, 1.53–1.82) and lower for individuals older than 50 years, compared with those younger than 50 (OR, 0.75; 95% CI, 0.62–0.92). There was no effect of socioeconomic status, but only 4 studies reported these data.

Conclusions

The prevalence of IBS varies among countries, as well as criteria used to define its presence. Women are at slightly higher risk for IBS than men. The effects of socioeconomic status have not been well described.

Section snippets

Search Strategy and Study Selection

A literature search was performed by using EMBASE Classic and EMBASE (1947 to October 2011) and MEDLINE (1948 to October 2011) to identify only cross-sectional surveys published in full that reported the prevalence of IBS in adults (aged 15 years and older). Studies were required to recruit participants from the general population or community. Those that reported the prevalence of IBS in convenience samples such as university students, employees at an institution, or those attending screening

Results

The search strategy identified 20,146 citations. From these we identified 390 that appeared to be relevant to the study question. There were 81 studies that fulfilled the eligibility criteria and represented 80 separate adult study populations (Supplementary Figure 1).2, 20, 21, 22, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84,

Discussion

This systematic review and meta-analysis has assembled data from all available and identified population-based cross-sectional surveys that report the prevalence of IBS in the community. It has demonstrated that prevalence varies strikingly, from 1% to more than 45%, according to the geographic location of the population under study. The criteria used to define presence of IBS also led to differences in prevalence, which was lowest when the Rome I criteria were used and highest with the

Acknowledgments

The authors thank Professor Paul Moayyedi for producing Figure 2 of the article, Mr Mark R. C. Lovell and Dr Cathy Yuhong Yuan for assisting us with the translation of foreign language articles, Professor Nicholas J. Talley and Dr G. Richard Locke III for answering our queries about their studies, and Dr Linda B. Olafsdottir for providing us with extra data concerning her study.

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    Conflicts of interest The authors disclose no conflicts.

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