Epidemiology of Irritable Bowel Syndrome in Albania

Abstract

Background and Aims: Irritable bowel syndrome (IBS) is a chronic condition, with a relatively high prevalence and represents a burden for the healthcare budgets. Knowing the prevalence of IBS is important for scientific and practical estimation of its impact. The recent Rome IV global study has shed light on the prevalence of IBS in many countries, but reports are lacking from other countries. The aim of this study was to assess the prevalence of IBS in Albania, a country from which we do not have relevant information. Method: A prospective study was carried out in order to find out the prevalence of IBS in Albania. The target population was a sample of at least 500 Albanian adults (from a population of 2.2 million adults in this country. The questionnaires were distributed to the general population through three University centers from different areas of the country, through family doctors, chosen randomly, and by door to door by volunteer medical students. The questionnaires were self-completed by the participants and included 29 items: biographical data, IBS symptoms based on the Rome IV criteria, the symptoms that accompany IBS and the quality of life (QoL). The prevalence of IBS in the studied population, the sex ratio, the subtypes of IBS and the prevalence of different symptoms were calculated. Results: We sent out 550 questionnaires and we received answers from 502 subjects (response rate 91%, 312 females, median age: 42 years). IBS was present in 43 cases (8.6%), without gender predominance. The IBS subtypes had the following values: IBS-C 58%, IBS-D 28% and IBS-M 14%. Women had a relatively higher risk for subtype IBS predominant constipation (OR=1.13, 95%CI: 0.32-3.95, p=0.84) but men appeared to be more prone to IBS predominant diarrhea (OR=1.3, 95%CI: 0.33-5.08, p=0.7). The most affected age was over 50 years and the least affected was between 18-30 years. Bloating was present in 81.4% of IBS respondents. The pain significantly influenced the daily activity in IBS: OR=12.9:1 (95% CI: 6.18-27.31, p<0.0001). Education seems to be an important risk factor; people with only middle school education or less had an OR=4.5 (95% CI: 2-10.54, p=0.0003) of developing IBS than people with a higher education. Conclusions: These are the first reported data on IBS in Albania. IBS in Albania is of 8.6%, more than the average data in the Rome IV global study, but in the range obtained from other studies. The most common type is IBS-C; there is no gender predominance; it is more common in less educated persons; the influence of pain on daily activity is higher in IBS.