Introduction
Gastrointestinal functional disorders, including irritable bowel syndrome (IBS), are the gastroenterological disorders with the most frequent epidemiology in the general population. Among university students (medical and nursing), there is an increased prevalence of IBS, so much so that it has repeatedly been called a "global challenge." However, despite this, data in such populations are still scarce and not fully represented in all geographic people considering the wide variability that the epidemiology of IBS encounters moving latitude and longitude. In southern Europe and, in detail, in Italy, data in this regard are lacking.
Aims & Methods
In this cross-sectional observational survey study (VANVITELLI-IBS Study), undergraduate medical and nursing students were enrolled and sent an anonymous questionnaire. The latter was sent only after a careful interview with the gastroenterologists included in the study that excluded red flags of organic gastrointestinal disease. Criteria suggestive for diagnosing IBS according to ROME IV were assessed in the questionnaire. In addition, clinic-demographic variables and variables related to university life (i.e., year of study, being on or off campus, possible receipt of scholarships or being in a delayed time-to-degree condition (i.e., outside prescribed time) were collected. In addition, the "Beck Anxiety Questionnaire Inventory" (BAI) and the "PREDIMED questionnaire" were provided. The former assesses anxiety symptoms, the latter the degree of adherence to the Mediterranean diet.
Results
Two hundred and fifty students were considered for enrolment; however, 89 participants were excluded (39 due to flags of non-functional gastrointestinal disorders and 50 refused to take the questionnaire). In the end, 161 patients were included. Of these, 34/161 met the criteria for IBS according to ROME IV [age 22 (21 - 25.25) years, 17 (50%) males and 17 (50%) females, 22 (65.7%) medical students and 12 (35.3%) nursing students] while 127/161 did not [age 22 (21 - 24) years, 59 (46.5%) males and 68 (53.5%) females, 59 (46.5%) medical students and 68 (53.5%) nursing students]. In addition, students who declared Bristol 1-2 stool in more than 25% of cases and Bristol 6-7 stool in less than 25% were 11/34 (32.35%) compatible with IBS-C. Those who declared an inverse percentage ratio (consistent with IBS-D) were 5/34 (14.7%). The remainder of the students (18/34, 52.9%) had a mixed phenotype (IBS-M). The rate of outside prescribed time was higher in IBS-positive than in IBS-negative (29.4% vs 4.7%, p=0.000168), while on the contrary, for that of perceived scholarship (14.7% vs 33.9%, p=0.035). BAI levels were different between positive and negative IBS [17.5 (10.5 - 40) vs 13 (7 - 20), p=0.002] as were those of PREDIMED score [4 (2.75 - 6) vs 7 (3 - 10), p=0.009]. In binary logistic regression, being outside the prescribed time was associated with a higher likelihood of IBS occurrence (OR: 8.403, p=0.000155); the opposite behaviour was for adherence to the Mediterranean diet (OR: 0.258, p=0.002). No correlations between the PREDIMED score and BAI (τ= - 0.38; p=0.493) and no significant changes in BAI (p=0.205) and PREDIMED (p=0.641) as a function of students' year of enrolment were found. More than half of the sample (61.75%) had moderate-to-severe anxiety levels, and 73.52% of the students adhered poorly to the Mediterranean diet in the IBS group.
Conclusion
This study confirms how IBS, in this setting, is a significant epidemiological problem and campaigns in favour of the Mediterranean diet and proper anxiety management could be helpful.
References
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