title: Rates of functional bowel disorders among Israeli Bedouins in rural areas compared with those who moved to permanent towns.
abstract: OBJECTIVE
  Half of Israeli Bedouin society has undergone a transition from nomadic existence to permanent towns, causing cultural and social upheaval. The aim was to compare rates of irritable bowel syndrome (IBS) and functional bowel disorders (FBDs) between Israeli Bedouins still living under rural conditions with those in permanent towns.
  
  
  METHODS
  Interviews were conducted in Arabic by trained Bedouin interviewers at 8 Bedouin clinics. The same interviewers surveyed the 2 sectors under identical sampling and interviewing conditions at the same time. FBDs were diagnosed by Rome II criteria.
  
  
  RESULTS
  One thousand seven hundred fifty-five Bedouins participated, 1018 from permanent towns and 737 from rural areas. Sixty percent were female (58.2% for rural and 62.0% for towns). The mean age was 39.1 +/- 14.1 years (39.0 +/- 14.3 years for towns, 39.2 +/- 13.9 years for rural; P = NS). The mean level of education was 4.3 +/- 5.4 years (4.6 +/- 5.6 years for towns, 3.7 +/- 5.2 years for rural; P < .0001). IBS was diagnosed in 9.4% of town and 5.8% of rural Bedouins ( P < .01). In contrast, rural Bedouins had significantly higher rates of functional abdominal bloating (7.9% vs 2.8%, P < .0001) and a marginally higher rate of functional constipation. Bedouins living in towns attributed their gastrointestinal symptoms to stress more than rural Bedouins did ( P < .05). Stress and poor global feeling of well-being were significant contributors for IBS in logistic regression models for both sectors.
  
  
  CONCLUSIONS
  Bedouins living in permanent towns have significantly higher rates of IBS than rural Bedouins. Although these findings might be associated with the stressful social upheaval that they have undergone, further study is needed to substantiate this point.
authors.affiliation: Department of Gastroenterology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel 84101. amy@bgumail.bgu.ac.il
authors.forename: Ami D
authors.initials: AD
authors.lastname: Sperber
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.forename: Pesach
authors.initials: P
authors.lastname: Shvartzman
authors.forename: Muhammed
authors.initials: M
authors.lastname: Abu-Rabia
authors.forename: Rasmieh
authors.initials: R
authors.lastname: Abu-Rabia
authors.forename: Muhammed
authors.initials: M
authors.lastname: Abu-Rashid
authors.forename: Khalil
authors.initials: K
authors.lastname: Albedour
authors.forename: Othaman
authors.initials: O
authors.lastname: Alkranawi
authors.forename: Alex
authors.initials: A
authors.lastname: Eisenberg
authors.forename: Alex
authors.initials: A
authors.lastname: Kazanoviz
authors.forename: Liyobov
authors.initials: L
authors.lastname: Mazingar
authors.forename: Alex
authors.initials: A
authors.lastname: Fich
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D018912:Arabs / Q000706:statistics & numerical data*; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D012307:Risk Factors; D012424:Rural Population; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014505:Urban Population