Abstract
Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder with a prevalence of 10% worldwide. There is a noteworthy lack of data from Africa, Eastern Europe and Arab countries especially Saudi Arabia. To date, no report about the effect of Altitude on IBS has been published. Therefore, we aimed to assess the association between altitude and IBS in terms of incidence and symptom severity.
Methods: We conducted this cross-sectional study in Taif and Jeddah, Saudi Arabia, in the period from January to February 2018. ROME IV criteria were used to define and classify different subtypes of IBS in patients (>18 years old) with no history of red flag symptoms or any other structural GI disease. Multiple logistic regression analysis was used to determine the significant risk factors of IBS.
Results: 1802 patients were included in the analysis. IBS showed a prevalence rate of 31.7%. Females had a higher rate of IBS (52.3% vs 47.7%, P-value = 0.058). IBS with mixed bowel habits (IBS-M) is the most prevalent type (36.9%). 75.7% of patients had increased severity of symptoms with high altitude. Spicy food is the most common food type to trigger IBS symptoms (32.1%). Living in low altitude (Jeddah) showed a decreased risk of developing IBS compared to high altitude (Taif) (OR = 0.07; 95% CI: 0.05-0.09). Patients with no family history were at lesser risk of having IBS (OR = 0.47; 95% CI: 0.36-0.63). Lack of physical activity and advancing in age are associated with an increase in the risk of IBS (OR = 3.19; 95% CI: 2.34-4.34) (OR = 1.01; 95% CI: 1-1.03), respectively.
Conclusions: Age, city, residence, marital status, occupation, average monthly income, family history, and physical activity are significant risk factors of IBS. High altitude increases the risk of developing IBS. These findings require further confirmation.