The epidemiology of irritable bowel syndrome among children and adolescents in Asia: a systematic review

Abstract

Aims: Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain and changing bowel habits including frequency and consistency. The aim of this study was to systematically review published literature on prevalence, risk factors and comorbid factors of IBS among children living in Asia. METHOD: A computer assisted search of PUB MED, CINHAL, and Index Medicus for South East Asia was carried out. Study selection criteria were; 1) Asian population based samples of children/adolescents; 2) Clear diagnostic criteria for IBS (Rome I, II or III); 3) Full manuscripts published in English. Selected articles were reviewed in depth; data were extracted and presented in descriptive form. RESULTS: Thirteen cross sectional studies which reported prevalence of IBS were included in the final analysis. Preva¬lence of IBS among Asian children and adolescents ranges from 2.8% to 25.7%. Nine studies have shown a higher prevalence of IBS in girls compared to boys. Studies from China have indicated untyped IBS as the commonest IBS subtype, while studies from Sri Lanka have shown approximately even distribution of all four subtypes. Clearly identi¬fied predisposing factors to develop IBS in Asian children included psychological stress, anxiety, depression, consump¬tion of alcohol and fatty food, smoking, and exposure to gastrointestinal infections. Comorbid factors of IBS reported among Asian children included an array of somatic symptoms, fatigue and psychological problems such as depression. CONCLUSIONS: According to published data, IBS is a significant problem among Asian children and adolescents. Female gender, exposure to stress, certain food habits, life styles and gastrointestinal infections predispose children to develop IBS in Asia.