World Gastroenterology Organisation Global Guideline Irritable bowel syndrome: a global perspective
IBS demographics and different presenting features between East and West
• As in the case of prevalence data, global information on presenting features also varies and comparisons of studies based on community data, outpatient clinic data, and hospital statistics are fraught with difficulties.
• Typical IBS symptoms are common in healthy population samples, but the majority of sufferers with IBS are not actually medically diagnosed. This may explain apparent differences between countries in the reported prevalence. Moststudies only count diagnosed IBS and not community prevalence.
• A study in China showed that the prevalence of IBS in south China was higher than that reported in Beijing, but lower than that reported in Western countries.
• Some studies in non-Western countries indicate: — A lack of female predominance (possibly due to differences in access and health care–seeking behaviors). In south China, for example, the male-to-female ratio is only 1 : 1.25 (in comparison with 1 : 2 in western Europe). — A close association between marked distress and IBS in men, in a mannersimilar to that found in women in Western studies. — Greater frequency of upper abdominal pain. — Lower impact of defecatory symptoms on a patient’s daily life (not evident in China or Mexico).
• Several studies suggest that among Afro-Caribbean Americans, in comparison with white individuals: — The stool frequency is lower. — The prevalence of constipation is higher.
• In Latin America, constipation predominance is more frequent than diarrhea predominance.
• Stool frequency appears to be greater in the Indian community as a whole—99%passed stools once or more per day. • In Mexico, 70% of patients have anxiety, 46% depression, and 40% both.
• In Mexico, IBS incurs a high economic impact due to a high use of medical resources.
• Clinical overlap between functional dyspepsia and IBS, defined according to the Rome III criteria, is very common in China.
• Psychological distress, life events, and negative coping style may play important roles in the pathogenesis of IBS. These factors may also influence the individual’s illness behavior and clinical outcome.
Long Term Sufferers
New IBS Sufferers
Life Long Sufferers
Where to go for treatment ?
While it is true that some countries in the West provide a better standard of care, any answer to this question would be somewhat subjective. Despite all the data showing the wide spread nature of IBS it is very clear that despite the growth of the problem, that it remains as illusive as the common cold to cure.
With that in mind, the best way to analyse this would be through the location of the Gastroenterologists and other medical professionals who treat the condition. In the last few years the unstoppable rise of FODMAPs as a treatment for IBS has certainly put Australia at the forefront.
Australia has in the past been at the leading edge of dietary recommendations as demonstrated by there embrace of the GI principles. Australia was far quicker to act, and far quicker to apply this philosophy to their diet. With the leader of FODMAPs emanating from Australia, once again they have stolen a march. We would recommend that IBS sufferers keep an eye out for the latest development from Australia.
In terms of the best Gastroenterologists, no place on earth has the resources of the USA. The nature of the health industry ensures that if you have no monetary issues, this is the place to go. If you have monetary issues and you are based in the UK, you face GP lottery. Some are wonderful and don’t give up, others are utterly apathetic once diagnoses has been delivered. We have provided some further data from the international study below: