A POPULATION-BASED PREVALENCE STUDY OF IRRITABLE BOWEL SYNDROME AND THE FUNCTIONAL GASTROINTESTINAL DISORDERS IN LATIN AMERICA

Abstract

Purpose: Existing epidemiologic studies of Functional Gastrointestinal Disorders (FGIDs) and Irritable Bowel Syndrome (IBS) focus upon homogenous cohorts of Caucasians in the U.S. and Western Europe, often utilizing non-population-based surveys. Studies in Latin America and the Developing World are lacking. This is the first population-based study to delineate the epidemiologic profile of FGIDs and IBS in the Latino population, utilizing an epidemiology surveillance system which is unique in Spanish-speaking Latin America. Methods: The study design is a cross-sectional survey with nested case-control component, using household interviews. The University of Nicaragua, Leon maintains a computerized population database for Western Nicaragua, population 200,000, facilitating rigorous sampling. The population is Hispanic meztizo, with small indigenous groups. The ROME II Modular Questionnaire serves as the core instrument, with translation and validation per Rome Committee standard. External validation was performed in 200 subjects. Potential associations with poverty, diet, abuse, domestic violence, and war trauma are examined with validated instruments. Organic disease is excluded with physician exam, CBC, stool exam and subset EGD. Results: Interim analysis is available for 1,617 subjects of the target enrollment of 3,000. The overall prevalence at least one functional disorder was 26%, with 31% and 20% in females and males, respectively. The prevalence of IBS was 13%, with 16% in females and 9%, in males (OR = 1.8, p <.001). The prevalence of functional dyspepsia was 4.5%, gender equal. Proctalgia fugax is suprisingly common, potentially reflecting differences in physiology, cultural expression, or language. There is no significant association between a positive FGID outcome and the validated poverty index. Conclusions: The ROME II Modular Questionnaire has been translated and validated in Spanish, facilitating the first population-based study of IBS and FGIDs in the Latino population and Latin America. IBS is common, 13%, with a nearly 2:1 female predominance. This ongoing effort will further delineate FGID prevalence and risk associations in this important population.Table: Functional GI Disorder Prevalence