Background Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with a significant impact on quality of life. However, data on the prevalence, clinical characteristics, and associations of symptom-based Rome IV IBS in the Saudi Arabian population are scarce. In this cross-sectional population-based study, we aimed to assess the prevalence, clinical features, and associations of symptom-based Rome IV IBS in adults across Saudi Arabia.

Methods We collected data from 2000 participants representing different regions of Saudi Arabia to ensure national representation. The study employed the following: 1) Participant Invitation from five distinct regions of KSA. 2) Questionnaire Administration, including demographic data and medical history, and the ROME IV Diagnostic Questionnaire (Arabic Version) to assess symptom-based criteria for Rome IV IBS. Patient Health Questionnaire (PHQ-12) (Arabic Version), a validated somatization questionnaire that scored participants’ non-GI symptoms, and Short Form (SF-8) (Arabic Version) to evaluate the quality of life (QOL) of participants. 3) Distribution Channels: The questionnaires were distributed via the internet and social media apps (WhatsApp, Twitter, Facebook, Snapchat). For participants with limited internet or social media access, in-person administration was used.

Results The prevalence of symptom-based Rome IV IBS in our study population was 3.9% (95% Confidence interval: 3.1%-4.9%). The overall IBS subtype distribution was 16.9% IBS-D, 31.0% IBS-C, 40.8% IBS-M, and 11.3% IBS-U. IBS was more common in females than males (76.1% vs. 64.9%, respectively), but the difference was not statistically significant (p=0.053). Also, there was no age difference between participants with or without IBS (p=0.742). Using the PHQ-12, IBS was significantly associated with high somatization compared to non-IBS participants (54.9% vs. 15.3%, p<0.001). The SF-8 score was significantly lower in IBS participants (41.9±9.2) compared to those without IBS (50.3±9.9, p<0.001). IBS participants used anti-diarrheal, laxatives, and antispasmodics more commonly than those without IBS.

Conclusions This study underscores the burden of symptom-based Rome IV IBS in Saudi Arabia. Understanding the clinical characteristics and associations of IBS is crucial for effective management and healthcare planning.