S1118 Global Prevalence and Determinants of Irritable Bowel Syndrome Among 43,286 Medical Students: A Systematic Review and Meta-Analysis

Introduction: Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder, often undiagnosed, with substantial impairment in quality of life. Medical students face various stressors that may increase risk of IBS. While global prevalence is approximately 9% (PMID: 32702295), studies reported higher prevalence among medical students. However, a meta-analysis synthesizing this evidence is lacking. Therefore, our aim was to 1) quantify global prevalence, 2) identify risk factors, and 3) explore variation by subgroups, eg, country, sex, and ROME criteria among medical students. Methods: We searched PubMed, EMBASE, MEDLINE, Web of Science, and CINAHL, and performed a citation search up to January, 2025. Observational studies reporting IBS prevalence among medical students (MD or equivalent) were included. The study was prospectively registered in PROSPERO (CRD42025633764). Pooled prevalence and odds ratios (ORs) were calculated using random effects model (DerSimonian and Laird) in R Studio (Version 2023.12.0). Results: Of 358 studies, 112 were eligible and comprised of 43,286 medical students. Most studies were from Saudi Arabia (n = 24). The pooled global prevalence was 21%, ranging from 7% in Benin to 47% in Guinea, with only 3 studies from North America. Prevalence varied by diagnostic criteria: Rome I, 16%; Rome II, 17%; Rome III, 23%; and Rome IV, 19%. Among IBS-positive students, IBS-Mixed was the most common subtype (36%). Women had higher prevalence than men (23% vs 19%). Key risk factors identified were family history (OR: 3.12, 95% CI: 2.42–4.01), followed by stress (2.83, 2.04–3.93), depression (2.77, 1.95–3.95), inadequate sleep (1.62, 1.15–2.28), and smoking (1.49, 1.19–1.87). Conclusion: Globally, 1 in 5 medical students reported having IBS, which is twice the prevalence observed in the general population (9%). Prevalence varied across countries, diagnostic criteria used, and sex. Future studies are needed to characterize burden in North American regions. Our results reinforce the association between a positive family history and the risk of IBS. Furthermore, routine exposure to academic stress may explain the relationship between IBS and psychological risk factors (eg, stress, depression) and support the role of the gut-brain axis in IBS. Incorporation of stress management and self-care support programs in medical curricula can reduce the burden of IBS and improve quality of life among medical students.