Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force.
OBJECTIVE
To study the profile of irritable bowel syndrome (IBS), and the frequency of such symptoms among the general population, in India.


METHODS
In this prospective, multi-center study, data were obtained from 2785 patients with chronic lower gastrointestinal symptoms (complainants) with no alarm feature and negative investigations for organic causes visiting physicians at 30 centers, and from 4500 community subjects (non-complainants), using separate questionnaires.


RESULTS
Most complainants were middle-aged (mean age 39.4 years) and male (1891; 68%). The common symptoms were: abdominal pain or discomfort (1958; 70%), abdominal fullness (1951; 70%); subjective feeling of constipation (1404 of 2656; 53%), or diarrhea (1252 of 2656, 47%), incomplete evacuation (2134; 77%), mucus with stools (1506; 54%), straining at stools (1271; 46%), epigastric pain (1364; 49%) and milk intolerance (906; 32%). Median stool frequency was similar in patients who felt they had constipation or those who felt they had diarrhea. Information to subtype symptoms using standard criteria was available in 1301 patients; of these, 507 (39%) had constipation-predominant IBS ( 3 <or= stools/week), 50 (4%) had diarrhea-predominant IBS (>3 stools/day) and 744 (57%) had indeterminate symptoms. Among non-complainants, most subjects reported daily defecation frequency of one (2520 [56%]) or two (1535 [34%]). Among non-complainants, 567 (12.6%) reported abdominal pain, 503 (11%) irregular bowel, 1030 (23%) incomplete evacuation, 167 (4%) mucus and 846 (18%) straining at stools; a combination of abdominal pain or discomfort relieved by defecation, and incomplete evacuation was present in 189/4500 (4.2%) community subjects.


CONCLUSIONS
Most patients with IBS in India are middle-aged men, and have a sense of incomplete evacuation and mucus with stools. Abdominal pain or discomfort is frequent but not universal. Importantly, stool frequency was similar irrespective of whether the patients felt having constipation or diarrhea. Most (90%) non-complainant subjects had 1 or 2 stools per day; symptoms complex suggestive of IBS was present in 4.2% of community subjects.
Department of Gastroenterology, SGPGI, Lucknow. ghoshal@sgpgi.ac.in
Uday C
UC
Ghoshal
Philip
P
Abraham
Chetan
C
Bhatt
Gourdas
G
Choudhuri
Shobna J
SJ
Bhatia
K T
KT
Shenoy
N H
NH
Banka
Kalyan
K
Bose
N P
NP
Bohidar
Karmabir
K
Chakravartty
N Chandra
NC
Shekhar
Nutan
N
Desai
Usha
U
Dutta
Goutam
G
Das
Sangeet
S
Dutta
V K
VK
Dixit
B D
BD
Goswami
R K
RK
Jain
Sunil
S
Jain
V
V
Jayanthi
Rakesh
R
Kochhar
Ajay
A
Kumar
Govind
G
Makharia
Shrikant V
SV
Mukewar
V G
VG
Mohan Prasad
Alok
A
Mohanty
A T
AT
Mohan
B S
BS
Sathyaprakash
B
B
Prabhakar
Mathew
M
Philip
E Peda
EP
Veerraju
Gautam
G
Ray
Ramesh Roop
RR
Rai
A K
AK
Seth
Atul
A
Sachdeva
Shivaram Prasad
SP
Singh
Ajit
A
Sood
Varghese
V
Thomas
Shridhar
S
Tiwari
Manu
M
Tandan
R
R
Upadhyay
J C
JC
Vij
D000328:Adult; D005260:Female; D005762:Gastroenterology; D006801:Humans; D007194:India / Q000453:epidemiology; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D012955:Societies, Medical