Severity of irritable bowel syndrome and its correlates among Middle East and North African medical students: a multicentric cross sectional study

Abstract Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder that is commonly reported among individuals experiencing high levels of stress, such as medical students. Despite its significance, data on the severity of IBS and its correlates remains scarce in the Middle East and North Africa (MENA) region. This study is a secondary analysis of a previously published multicenter study and aimed to evaluate the severity of irritable bowel syndrome (IBS) and identify the correlates of severe IBS among medical students with Rome IV-confirmed IBS. This multicentric cross-sectional study was conducted across 27 medical faculties in seven MENA countries) from March until May 2024. A bilingual (Arabic/English) online self-reported questionnaire was used to assess IBS severity via the validated IBS-Symptom Severity Scale. Data analysis was performed using SPSS, version 26. Remission, mild, moderate, and severe IBS symptoms were detected among 15.28%, 31.38%, 36.60%, and 16.73% of the participants, respectively. Students with severe IBS symptoms had a significantly higher mean age compared to other students ( p = 0.019). Among students with severe IBS symptoms, the proportion of overweight/obese (18.5%) was significantly higher than that of underweight/normal weight (16.1%) ( p = 0.022). Furthermore, among students with severe IBS symptoms, there were significantly higher proportions of positive depression ( p < 0.001), anxiety ( p < 0.001), and history of food or drug hypersensitivity ( p < 0.001). In the Generalized linear model – Adjusted Poisson regression analysis for determination of the correlates of severe IBS among medical students, Anxious students [aPR = 1.87 (95% CI 1.418–2.461)] and depressed students [aPR = 1.86 (95% CI 1.512–2.284)] were significantly more likely to experience severe IBS symptoms ( p < 0.001*). Similarly, students with a history of food or drug hypersensitivity were significantly more likely to have severe IBS [aPR = 1.29 (95% CI 1.079–1.546)] ( p = 0.005). The present study demonstrated that more than half of students with IBS In the MENA region exhibited moderate to severe symptoms. Psychological comorbidities were predominant among students with severe IBS symptoms, highlighting the strong association between mental health conditions and IBS symptom severity in this population.