An Epidemiologic Study of Irritable Bowel Syndrome in Adolescents and Children in China: A School-Based Study

Abstract

ABSTRACT. Objectives. To explore the prevalence of irritable bowel syndrome (IBS) and its distribution characteristics of adolescents and children in China and its contributing factors.Methods. This study was a stratified, randomized study by clustering samples, which involved 5403 students whose age range was 6 to 18 years from 9 schools, and was conducted in Heilongjiang Province and Shanghai. All students studied were requested to fill in a questionnaire. IBS was diagnosed according to Rome II criteria.Results. The prevalence of IBS according to Rome II criteria in adolescents and children in China was 13.25%. The ratio of boys to girls was 1:1.8. There was a higher prevalence (14.02%) of IBS in Heilongjiang province than that (11.72%) in Shanghai. The prevalence in children 12 years and younger was not statistically significantly higher than that of adolescents 13 years and older (11.86% and 11.44%, respectively). The prevalence of IBS in minority students (21.15%) was not statistically significantly higher than that in Han race students (16.08%). Our study indicated that psychological factors, food habit, bad exterior environment, personal habits, and family conditions might be important contributing factors, and exposure to coldness (odds ratio: 2.83) is most prominent.Conclusion. IBS was a common disorder in adolescents and children in China. The prevalence of IBS in adolescents and children was different in different geographic areas. Our study indicated that IBS in adolescents and children might have possible relations with psychological factors, food habit, bad exterior environment, and family condition. I rritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder. In the world, the epidemiologic studies indicate that IBS in adults is a common disorder that deserved more attention. In Western countries, the prevalence of IBS (Rome criteria) in adults was 8% to 23%; among them, 10% to 15% in European and North American countries and 11% to 17% in Oceania. In Africa, the rate was ϳ10%. In Asia, it was ϳ5%. 1-3 In view of the common understanding about adult IBS, some scholars in Western countries had undertaken many epidemiologic studies including the prevalence of IBS and its risk factors in adolescents, suggesting that IBS in a community-based adolescent population was also common. An epidemiologic study in Italy indicated that the prevalence of IBS in children aged birth to 12 years is 13.9%. 4 In the United states, Walker et al 5 tested the hypothesis that most children with recurrent abdominal pain could be classified into 1 or more of the symptom subtypes defined by the Pediatric Rome Criteria; moreover, 44.9% of children with recurrent abdominal pain were consistent with the Pediatric Rome Criteria for IBS. In Moscow, a study by Reshetnikov in students who were 14 to 17 years of age indicated that the prevalence of IBS was 14% to 24%; among them, 21% had to see doctors in different hospitals. Consequently, the medical costs were so high that many families could not affo...

Irritable bowel syndrome and its associated factors in adolescents

“…9,10,14,15 We found the prevalence of IBS among high school students to be 6.0%. This finding was lower than the 11.44-17.35% among Chinese adolescents aged 13-17 years using the Rome II criteria.…”

“…In contrast, Liu Dong et al did not find a relationship between the stress of school work and parents' disciplinary forms to IBS. 14 Park et al also found no significant relationship between examination-related stress and IBS. 3 However, the higher prevalence among students with IBS who experienced stress by scolding and corporal punishment were reported by other previous studies.…”

“…This finding was lower than the 11.44-17.35% among Chinese adolescents aged 13-17 years using the Rome II criteria. 14 The prevalence of IBS varies greatly among epidemiological studies, potentially due to several factors such as inclusion of different diagnostic criteria, gender distributions, and willingness to respond to questionnaires. The Manning criteria appears to yield higher values compared to either the Rome I or II criteria.…”

“…Similarly, other studies in Asian countries found no significant difference in the proportion of males and females. 14,17 To assess for an association between IBS and socioeconomic status, we divided subjects into 3,280,000. There was no significant difference in socioeconomic status between the IBS and non-IBS groups (P=1.000).…”

“…1,2 Associations between IBS symptoms and specific foods has also been reported, most commonly those containing milk and wheat products, caffeine, fructose, and certain meats. 14,[18][19][20][21][22] Antibiotic therapy has also been suggested to increase the development of IBS after traveler's diarrhea resulting from prolonged changes in bowel flora. 20 Mendall et al showed that the association between antibiotic use and IBS could be causal.…”