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Global burden of irritable bowel syndrome: trends, predictions and risk factors

Abstract

Irritable bowel syndrome (IBS) is one of the most common disorders of gut–brain interaction worldwide, defined according to patterns of gastrointestinal symptoms as described by the Rome diagnostic criteria. However, these criteria, developed with reference to research conducted largely in Western populations, might be limited in their applicability to other countries and cultures. Epidemiological data show a wide variation in the prevalence of IBS globally and more rigorous studies are needed to accurately determine any differences that might exist between countries as well as the potential explanations. The effects of IBS on the individual, in terms of their quality of life, and on health-care delivery and society, in terms of economic costs, are considerable. Although the magnitude of these effects seems to be comparable between nations, their precise nature can vary based on the existence of societal and cultural differences. The pathophysiology of IBS is complex and incompletely understood; genetics, diet and the gut microbiome are all recognized risk factors, but the part they play might be influenced by geography and culture, and hence their relative importance might vary between countries. This Review aims to provide an overview of the burden of IBS in a global context, to discuss future implications for the care of people with IBS worldwide, and to identify key areas for further research.

Key points

  • Irritable bowel syndrome (IBS) is one of the most common disorders of gut–brain interaction, estimated to affect around 1 in 10 people globally.

  • Prevalence rates appear to differ between countries, but the magnitude of the effect of IBS, in terms of cost and quality of life, seems comparable around the world.

  • The pathophysiology of IBS is complex and the role of risk factors such as genetics, diet and the microbiome might operate differently, dependent on geography.

  • As developing countries increasingly adopt a Western diet and lifestyle, we might see a corresponding increase in IBS prevalence rates, a trend that might also reflect increasing awareness of the condition.

  • Even if prevalence rates remain unchanged, projections of global population growth alone indicate that there will be many more people living with IBS worldwide.

  • Well-designed and adequately funded research, which is multi-cultural in design and encourages global collaboration, is needed to further advance our understanding of IBS and promote optimized patient care.

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Fig. 1: Global prevalence of IBS.
Fig. 2: The effects of IBS.
Fig. 3: Proposed pathophysiological mechanisms in IBS.

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Black, C.J., Ford, A.C. Global burden of irritable bowel syndrome: trends, predictions and risk factors. Nat Rev Gastroenterol Hepatol 17, 473–486 (2020). https://doi.org/10.1038/s41575-020-0286-8

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