Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2012; 18(44): 6475-6480
Published online Nov 28, 2012. doi: 10.3748/wjg.v18.i44.6475
Rome III survey of irritable bowel syndrome among ethnic Malays
Yeong Yeh Lee, Anuar Waid, Huck Joo Tan, Andrew Seng Boon Chua, William E Whitehead
Yeong Yeh Lee, Anuar Waid, Department of Medicine, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Malaysia
Huck Joo Tan, Department of Gastroenterology, Sunway Medical Center, Petaling Jaya 46150, Malaysia
Andrew Seng Boon Chua, 31 Lebuh Raya Raman Ipoh, Ipoh Garden South, Ipoh 31400, Malaysia
William E Whitehead, Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, CA 27599-7080, United States
Author contributions: Lee YY participated in the design, analysis and writing of the manuscript; Waid A performed the studies and analysis; Tan HJ, Chua ASB and Whitehead WE contributed to study design and writing of the manuscript.
Supported by Malaysian Society of Gastroenterology and Hepatology Research Award 2008
Correspondence to: Yeong Yeh Lee, MD, MRCP, Department of Medicine, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Kota Bahru, Malaysia. justnleeyy@gmail.com
Telephone: +60-9-7663448 Fax: +60-9-7648277
Received: July 4, 2012
Revised: August 14, 2012
Accepted: August 16, 2012
Published online: November 28, 2012
Abstract

AIM: To survey irritable bowel syndrome (IBS) using Rome III criteria among Malays from the north-eastern region of Peninsular Malaysia.

METHODS: A previously validated Malay language Rome III IBS diagnostic questionnaire was used in the current study. A prospective sample of 232 Malay subjects (80% power) was initially screened. Using a stratified random sampling strategy, a total of 221 Malay subjects (112 subjects in a “full time job” and 109 subjects in “no full time job”) were recruited. Subjects were visitors (friends and relatives) within the hospital compound and were representative of the local community. Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires. Subjects with IBS were sub-typed into constipation-predominant, diarrhea-predominant, mixed type and un-subtyped. Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.

RESULTS: IBS was present in 10.9% (24/221), red flags in 22.2% (49/221) and psychosocial alarm features in 9.0% (20/221). Red flags were more commonly reported in subjects with IBS (83.3%) than psychosocial alarm features (20.8%, P < 0.001). Subjects with IBS were older (mean age 41.4 years vs 36.9 years, P = 0.08), but no difference in gender was noted (P = 0.4). Using univariable analysis, IBS was significantly associated with a tertiary education, high individual income above RM1000, married status, ex-smoker and the presence of red flags (all P < 0.05). In multiple logistic regression analysis, only the presence of red flags was significantly associated with IBS (odds ratio: 0.02, 95%CI: 0.004-0.1, P < 0.001). The commonest IBS sub-type was mixed type (58.3%), followed by constipation-predominant (20.8%), diarrhea-predominant (16.7%) and un-subtyped (4.2%). Four of 13 Malay females (30.8%) with IBS also had menstrual pain. Most subjects with IBS had at least one red flag (70.8%), 12.5% had two red flags and 16.7% with no red flags. The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS.

CONCLUSION: Using the Rome III criteria, IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.

Keywords: Irritable bowel syndrome, Malays, Prevalence, Rome III criteria, Malaysia