Stress and a Sedentary Lifestyle Are Associated With Rising Rates of Irritable Bowel Syndrome in Medical Students: A Cross- sectional Study

Abstract

Introduction: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that can produce a negative impact in the quality of life in those affected. Medical students present high rates of emotional and psychological stress that may favor the appearance of IBS. Likewise, the diagnosis of IBS is more frequent in senior medical students. We hypothesized that stress and sedentary lifestyle are associated to the rising rates of IBS in medical students. Methods: We conducted a population- based cross- sectional study among medical students at a medical school in Lima- Peru from February, 2015 to March, 2015. This medical school includes a 7 year curriculum, comprised of 3 years of fundamentals and 4 years of clinical training. We invited medical students during their clinical rotations to participate in the study. A sample of 128 subjects was calculated to achieve a power of 80%, and 95% confidence interval. Data was collected using a written anonymous survey that included demographic information, a validated Spanish version of the Rome III questionnaire, and the Self - reported Stress Status questionnaire. Sedentary lifestyle was defined by the absence of practicing any sport at least once a week. We performed univariate analysis, and multivariate logistic regression analysis to adjust for other variables. Results: A total of 346 medical students participated in the study (female:male: 0.9). The overall prevalence of IBS was 9.5% (n= 33). The prevalence of IBS significantly increased among the 4 years of clinical training (4th year: 6.8%, 5th year: 4.8%, 6th year: 12.6%, 7th year: 18%) (P < 0.01). Likewise, the prevalence of stress had a tendency to increase during the school years (4th year: 23.9%, 5th year: 28.6%, 6th year: 40.8 %, 7th year: 32%) (P=0.08). On univariate analysis history of psychiatric pathology (P < 0.01), sedentary lifestyle (P < 0.01), stress (P < 0.001), and intern year (P < 0.01), were associated with IBS. On multivariate analysis, only sedentary lifestyle (OR: 3.21; 95% IC: 1.25 - 8.23; P < 0.01) and stress (OR: 3.04; 95% IC: 1.36- 6.77; P < 0.01) were significantly associated to the diagnosis of IBS. Conclusion: There is a rising prevalence of IBS in medical students during clinical training in Peru. Both stress and sedentary lifestyle were significantly associated to the diagnosis of IBS. Future studies should focus in lifestyle modification strategies to reduce the rising rates of IBS in this group.