Background Functional Bowel Disorders (FBDs) significantly impact the quality of life and healthcare utilization. However, little is known about the prevalence and demographic distribution of FBDs in the Saudi Arabian population. We aimed to address this gap by conducting a national survey.

Methods We analyzed data from a population-based survey of 2000 participants across Saudi Arabia (KSA). To ensure national representation, participants were invited from five different regions of KSA. The survey included four components: 1) Demographic and Medical History, 2) ROME IV Diagnostic Questionnaire (Arabic-Version), and 3) The Short Form (SF-8) (Arabic Version) for evaluation of quality of life (QoL). Questionnaires were distributed via the Internet and social media apps (WhatsApp, Twitter, Facebook, Snapchat). In cases where internet usage was low or not feasible, participants were contacted in person, and the questionnaire was filled out electronically.

Results Out of the 2000 invited participants, 1834 responded to the whole questionnaire with an excellent response rate of 91.7%. The respondents included 1198 women (65.3%), and 636 men (34.7%) with a mean age of 34.3±13.9 years (range: 18-77 years). The prevalence (95%CI) of census-adjusted Rome IV FBDs in our study population was as follows: 1) Irritable Bowel Syndrome (IBS): 3.9% (3.1%-4.9%), 2) Functional Constipation: 17.4% (15.8%-19.3%), 3) Functional Diarrhea: 2.1% (1.6%-2.9%), 4) Functional Bloating or Distention: 1.6% (1.1%-2.3%), 5) Opioid-Induced Constipation: 1.3% (0.8%-1.9%), 6) Unspecified FBDs: 8.2% (7.1%-9.6%), and 7) Any Rome IV FBD: 32.8% (30.7%-35.0%). FBDs were significantly (p<0.001) more common in females (73.8%) than males (26.2%).

However, there was no age difference between participants with or without FBDs (p=0.114). Participants with FBD had a lower SF-8 score than those who were free of FBDs (47.1±9.5 vs. 51.4±9.9, p<0.001). They were more likely to have consulted physicians for their GI condition during the last year (54.4% vs. 47.9%, p =0.046).

Conclusions Nearly one-third of adults in the general Saudi Arabian population meet the Rome IV criteria for FBDs. These disorders significantly impact QoL and increase the use of gastrointestinal healthcare services.