Psychosocial and Lifestyle Determinants of Irritable Bowel Syndrome Among Medical Students: A Cross-sectional Analytical Study from Northern Bangladesh

Open Access

Abstract

Background: Irritable bowel syndrome (IBS) among medical students is often discussed as a count of cases. Less is recorded about which psychosocial and lifestyle items actually separate students who meet diagnostic criteria from those who do not. Objectives: To examine associations of self-reported stress, family history and selected lifestyle characteristics with Rome III IBS among medical students. Methods & Materials: A cross-sectional analytical study was conducted among undergraduate students of Rangpur Medical College from December 2019 to May 2020. Five hundred students aged 18-27 years completed a structured interview after written consent. Students with self-reported organic gastrointestinal disease, previous gastrointestinal surgery or alarm features were excluded. The outcome was Rome III IBS. Psychosocial items were self-reported stress and a family history of IBS. Lifestyle items were place of residence, source of daily food, regular exercise, current smoking and NSAID use. For each item the prevalence of IBS, Wilson 95% confidence interval (CI), absolute risk difference and unadjusted odds ratio (OR) were calculated. Comparisons used the chi-square test or Student t test. A p value <0.05 was taken as significant. Results. Rome III IBS was present in 105 of 500 students (21.0%; 95% CI 17.7-24.8). Prevalence was 70.0% (95% CI 61.3-77.5) in students who reported stress and 5.5% (95% CI 3.6-8.3) in those who did not (risk difference 64.5 percentage points; OR 39.89, 95% CI 22.15-71.84; χ² = 228.51; p < 0.001). Prevalence was 72.7% (95% CI 61.9-81.4) with a family history of IBS and 11.6% (95% CI 8.9-15.0) without (risk difference 61.1 percentage points; OR 20.35, 95% CI 11.36-36.47; χ² = 146.80; p < 0.001). Hostel residence was associated with IBS (OR 1.95, 95% CI 1.08-3.53; p = 0.025). Source of daily food, regular exercise, current smoking, NSAID use and mean body-mass index were not associated with IBS. Conclusion. In this sample the psychosocial items, stress and family history, identified most students with IBS. Among the lifestyle items only hostel residence showed a modest association. Food source, exercise, smoking and NSAID use did not.