title: Rome III survey of irritable bowel syndrome among ethnic Malays.
abstract: OBJECTIVE
  To survey irritable bowel syndrome (IBS) using Rome III criteria among Malays from the north-eastern region of Peninsular Malaysia.
  
  
  METHODS
  A previously validated Malay language Rome III IBS diagnostic questionnaire was used in the current study. A prospective sample of 232 Malay subjects (80% power) was initially screened. Using a stratified random sampling strategy, a total of 221 Malay subjects (112 subjects in a "full time job" and 109 subjects in "no full time job") were recruited. Subjects were visitors (friends and relatives) within the hospital compound and were representative of the local community. Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires. Subjects with IBS were sub-typed into constipation-predominant, diarrhea-predominant, mixed type and un-subtyped. Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.
  
  
  RESULTS
  IBS was present in 10.9% (24/221), red flags in 22.2% (49/221) and psychosocial alarm features in 9.0% (20/221). Red flags were more commonly reported in subjects with IBS (83.3%) than psychosocial alarm features (20.8%, P < 0.001). Subjects with IBS were older (mean age 41.4 years vs 36.9 years, P = 0.08), but no difference in gender was noted (P = 0.4). Using univariable analysis, IBS was significantly associated with a tertiary education, high individual income above RM1000, married status, ex-smoker and the presence of red flags (all P < 0.05). In multiple logistic regression analysis, only the presence of red flags was significantly associated with IBS (odds ratio: 0.02, 95%CI: 0.004-0.1, P < 0.001). The commonest IBS sub-type was mixed type (58.3%), followed by constipation-predominant (20.8%), diarrhea-predominant (16.7%) and un-subtyped (4.2%). Four of 13 Malay females (30.8%) with IBS also had menstrual pain. Most subjects with IBS had at least one red flag (70.8%), 12.5% had two red flags and 16.7% with no red flags. The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS.
  
  
  CONCLUSIONS
  Using the Rome III criteria, IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.
authors.affiliation: Department of Medicine, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Malaysia. justnleeyy@gmail.com
authors.forename: Yeong Yeh
authors.initials: YY
authors.lastname: Lee
authors.forename: Anuar
authors.initials: A
authors.lastname: Waid
authors.forename: Huck Joo
authors.initials: HJ
authors.lastname: Tan
authors.forename: Andrew Seng Boon
authors.initials: AS
authors.lastname: Chua
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data*; D003248:Constipation / Q000175:diagnosis / Q000208:ethnology; D003967:Diarrhea / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D016015:Logistic Models; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult