title: The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review.
abstract: The global prevalence of IBS is difficult to ascertain, particularly in light of the heterogeneity of published epidemiological studies. The aim was to conduct a literature review, by experts from around the world, of community-based studies on IBS prevalence.
  
  
  
  Searches were conducted using predetermined search terms and eligibility criteria, including papers in all languages. Pooled prevalence rates were calculated by combining separate population survey prevalence estimates to generate an overall combined meta-prevalence estimate. The heterogeneity of studies was assessed.
  
  
  
  1451 papers were returned and 83, including 288 103 participants in 41 countries, met inclusion criteria. The mean prevalence among individual countries ranged from 1.1% in France and Iran to 35.5% in Mexico. There was significant variance in pooled regional prevalence rates ranging from 17.5% (95% CI 16.9% to 18.2%) in Latin America, 9.6% (9.5% to 9.8%) in Asia, 7.1% (8.0% to 8.3%) in North America/Europe/Australia/New Zealand, to 5.8% (5.6% to 6.0%) in the Middle East and Africa. There was a significant degree of heterogeneity with the percentage of residual variation due to heterogeneity at 99.9%.
  
  
  
  The main finding is the extent of methodological variance in the studies reviewed and the degree of heterogeneity among them. Based on this, we concluded that publication of a single pooled global prevalence rate, which is easily calculated, would not be appropriate or contributory. Furthermore, we believe that future studies should focus on regional and cross-cultural differences that are more likely to shed light on pathophysiology.
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ami D
authors.initials: AD
authors.lastname: Sperber
authors.affiliation: 2nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Dumitrascu
authors.affiliation: Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Seiryo Aoba, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Fukudo
authors.affiliation: Division of Gastroenterology, Mt. Sinai School of Medicine, Mind-Body Digestive Center, New York, New York, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Gerson
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, India.
authors.forename: Uday C
authors.initials: UC
authors.lastname: Ghoshal
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Kok Ann
authors.initials: KA
authors.lastname: Gwee
authors.affiliation: Durham University School of Medicine, Pharmacy and Health, Wolfson Research Institute, Stockton-on-Tees, UK.
authors.forename: A Pali S
authors.initials: APS
authors.lastname: Hungin
authors.affiliation: Department of Gastroenterology, St. George's Hospital, London, UK.
authors.forename: Jin-Yong
authors.initials: JY
authors.lastname: Kang
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Minhu
authors.affiliation: Laboratory of Liver, Pancreas and Motility (HIPAM), Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autonoma de Mexico (UNAM), Hospital General de México, Mexico City, Mexico.
authors.forename: Max
authors.initials: M
authors.lastname: Schmulson
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Arkady
authors.initials: A
authors.lastname: Bolotin
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Freud
authors.affiliation: Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: William
authors.initials: W
authors.lastname: Whitehead
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D007843:Latin America / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012107:Research Design / Q000592:standards*; D014481:United States / Q000453:epidemiology
keywords: EPIDEMIOLOGY; FUNCTIONAL BOWEL DISORDER; IRRITABLE BOWEL SYNDROME