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The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review
  1. Ami D Sperber1,
  2. Dan Dumitrascu2,
  3. Shin Fukudo3,
  4. Charles Gerson4,
  5. Uday C Ghoshal5,
  6. Kok Ann Gwee6,
  7. A Pali S Hungin7,
  8. Jin-Yong Kang8,
  9. Chen Minhu9,
  10. Max Schmulson10,
  11. Arkady Bolotin1,
  12. Michael Friger1,
  13. Tamar Freud1,
  14. William Whitehead11
  1. 1Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
  2. 22nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania
  3. 3Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Seiryo Aoba, Japan
  4. 4Division of Gastroenterology, Mt. Sinai School of Medicine, Mind-Body Digestive Center, New York, New York, USA
  5. 5Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, India
  6. 6Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  7. 7Durham University School of Medicine, Pharmacy and Health, Wolfson Research Institute, Stockton-on-Tees, UK
  8. 8Department of Gastroenterology, St. George's Hospital, London, UK
  9. 9Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
  10. 10Laboratory of Liver, Pancreas and Motility (HIPAM), Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autonoma de Mexico (UNAM), Hospital General de México, Mexico City, Mexico
  11. 11Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Professor Ami D Sperber, Emeritus Professor of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel; amiroie{at}me.com

Abstract

Objectives The global prevalence of IBS is difficult to ascertain, particularly in light of the heterogeneity of published epidemiological studies. The aim was to conduct a literature review, by experts from around the world, of community-based studies on IBS prevalence.

Design Searches were conducted using predetermined search terms and eligibility criteria, including papers in all languages. Pooled prevalence rates were calculated by combining separate population survey prevalence estimates to generate an overall combined meta-prevalence estimate. The heterogeneity of studies was assessed.

Results 1451 papers were returned and 83, including 288 103 participants in 41 countries, met inclusion criteria. The mean prevalence among individual countries ranged from 1.1% in France and Iran to 35.5% in Mexico. There was significant variance in pooled regional prevalence rates ranging from 17.5% (95% CI 16.9% to 18.2%) in Latin America, 9.6% (9.5% to 9.8%) in Asia, 7.1% (8.0% to 8.3%) in North America/Europe/Australia/New Zealand, to 5.8% (5.6% to 6.0%) in the Middle East and Africa. There was a significant degree of heterogeneity with the percentage of residual variation due to heterogeneity at 99.9%.

Conclusions The main finding is the extent of methodological variance in the studies reviewed and the degree of heterogeneity among them. Based on this, we concluded that publication of a single pooled global prevalence rate, which is easily calculated, would not be appropriate or contributory. Furthermore, we believe that future studies should focus on regional and cross-cultural differences that are more likely to shed light on pathophysiology.

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