Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2017; 23(37): 6788-6801
Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6788
Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review
M Masudur Rahman, Sanjiv Mahadeva, Uday C Ghoshal
M Masudur Rahman, Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka 1000, Bangladesh
Sanjiv Mahadeva, Division of Gastroenterology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
Uday C Ghoshal, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Author contributions: Rahman MM reviewed the literature and wrote the first draft of the paper; Mahadeva S contributed to writing the paper and edited it; Ghoshal UC conceived the idea, reviewed the literature and contributed to writing the paper and edited it extensively.
Conflict-of-interest statement: None of the authors has any conflict of interest to declare in relation to the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Uday C Ghoshal, MD, DNB, DM, FACG, RFF, FNAMS, Professor, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow 226014, India. udayghoshal@gmail.com
Telephone: +91-522-2494405 Fax: +91-522-2668078
Received: June 23, 2017
Peer-review started: June 26, 2017
First decision: July 27, 2017
Revised: August 23, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: October 7, 2017
Abstract

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients’ quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.

Keywords: Epidemiology, Functional gastrointestinal disorders, Irritable bowel syndrome, Asia, Symptom, Constipation, Diarrhea

Core tip: The epidemiology, clinical presentation and management of irritable bowel syndrome (IBS) may vary in different geographical regions due to differences in diet, gastrointestinal infection and infestations, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Asia is geographically and socio-demographically diverse. In this context, India, Bangladesh and Malaysia share some similarities: (1) large population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review aims to explore clinical and epidemiological data on IBS from these three major nations in South and South-East Asia.