Determinants and frequency of irritable bowel syndrome in a German sample

Abstract

Background: To date there is no study that has estimated the prevalence of irritable bowel syndrome (IBS) in Germany according to the current Rome III criteria. The aim of the present study was to investigate the prevalence of IBS in a non-clinical German sample. Furthermore, we investigated the association of IBS with socio-demographic and psychological risk factors.

Methods: Baseline data from a prospective cohort study were analysed, including the IBS Module of the Rome III Diagnostic Questionnaires and validated psychometric scales including the Patient Health Questionnaire-15 (PHQ-15), the Big Five Inventory (BFI), the Perceived Stress Questionnaire (PSQ-5), and the Whiteley-Index (WI-7). The study population was compared to the German general population to appraise its representativeness. Multivariate logistic regression analyses were performed to identify possible risk factors associated with IBS.

Results: Between January 2011 and September 2012, 2419 persons participated (female 54.0 %, mean age 37.4 ± 14.9 years). According to the Rome III criteria, 401 participants (16.6 %) suffered from IBS. Five predictors were independently associated with IBS: previous traveller’s diarrhoea infection (OR = 1.76; 95 % CI = 1.34 to 2.31), higher somatic symptom burden (OR = 1.15; 95 % CI = 1.07 to 1.23), increased level of hypochondriasis (OR = 2.04; 95 % CI = 1.54 to 2.70), increased vulnerability to diarrhoea under stress (OR = 3.88; 95 % CI = 3.21 to 4.68) and perceived stress (OR = 1.43; 95 % CI = 1.04 to 1.99).

Conclusions: Our analyses yielded a relatively high IBS prevalence estimate, compared to studies published more than ten years ago. This might partially be explained by the fact that the time criterion of the Rome III criteria (at least 3 days/month in last 3 months) is more inclusive compared to the time criterion of the Rome II criteria (at least 12 weeks, which need not be consecutive, in the preceding 12 months).

Zusammenfassung

Hintergrund: Die Prävalenz des Reizdarmsyndroms (RDS) in Deutschland entsprechend der aktuellen ROM-III-Kriterien wurde bislang noch nicht untersucht. Ziel der vorliegenden Studie war die Einschätzung der RDS-Prävalenz in einer nicht-klinischen Stichprobe in Deutschland. Darüber hinaus wurden im Rahmen der Studie Zusammenhänge zwischen dem RDS und potenziellen sozio-demografischen und psychologischen Risikofaktoren untersucht.

Methoden: Die Baseline-Daten einer prospektiven RDS-Kohorten-Studie wurden ausgewertet. Diese beinhalteten u. a. das RDS-Modul der ROM-III-Kriterien und validierte psychometrische Skalen wie den Patient Health Questionnaire-15 (PHQ-15), das Big Five Inventory (BFI), das Perceived Stress Questionnaire (PSQ-5) und den Whiteley-Index (WI-7). Die Studienpopulation wurde hinsichtlich relevanter Merkmale mit der deutschen Wohnbevölkerung verglichen, um Rückschlüsse auf ihre Repräsentativität ziehen zu können. Um mögliche Risikofaktoren für das Vorliegen eines RDS zu identifizieren, wurden multiple logistische Regressionen gerechnet.

Ergebnisse: Zwischen Januar 2011 und September 2012 haben 2419 Personen an der Studie teilgenommen (Durchschnittsalter 37,4 ± 14,9 Jahre, 54 % Frauen). Entsprechend den ROM-III-Kriterien lag bei 401 Teilnehmern (16,6 %) ein RDS vor. Fünf unabhängige Prädiktoren waren mit dem Vorliegen eines RDS assoziiert: eine Erkrankung an einer Reisediarrhö in der Vergangenheit (OR = 1,76; 95 % CI = 1,34 bis 2,31), eine starke somatische Symptombelastung (OR = 1,15; 95 % CI 1,07 bis 1,23), erhöhte Hypochondrie-Neigung (OR = 2,04; 95 % CI 1,54 bis 2,70), erhöhte Vulnerabilität für Diarrhö bei Stress (OR = 3,88; 95 % CI = 3,21 bis 4,68) und das wahrgenommene Ausmaß an Stress (OR = 1,43; 95 % CI = 0,04 bis 1,99).

Schlussfolgerung: Verglichen mit anderen Studien ergaben unsere Analysen eine relativ hohe Schätzung der RDS-Prävalenz. Dies könnte teilweise daran liegen, dass die ROM-III-Kriterien weniger restriktiv als die ROM-II-Kriterien sind.

Schlüsselwörter

Darm - Colon irritabile - chronisch entzündliche Darmerkrankung - Risikofaktoren - Hypochondrie - Diarrhö

Key words

intestines - irritable bowel syndrome - chronic inflammatory bowel disease - risk factors - hypochondriasis - diarrhoea

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