Prevalence and pattern of irritable bowel syndrome among patients attending the gastroenterology outpatient clinic in Mulago Hospital

Abstract

Background: Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain or discomfort is related to defecation or a change in bowel habit. Patients with IBS are seen by clinicians among patients attending the outpatient gastroenterology clinic in Mulago hospital but the actual prevalence of IBS among these patients is not known. The clinical pattern among patients diagnosed with IBS attending the gastroenterology outpatient clinic is also not known. The socio-demographic characteristics that are associated with IBS among these outpatients are also not known. The study was done to determine the prevalence and pattern of IBS among patients attending the GI outpatient clinic in order to guide clinicians in planning for the management of these patients. Study objectives: To determine the prevalence, clinical pattern and socio-demographic characteristics of IBS among patients attending the gastroenterology outpatient clinic in Mulago hospital. Methods: This was a descriptive cross-sectional study which took place between November 2011 and February 2012. It was conducted in the gastroenterology outpatients clinic in Mulago hospital. Three hundred and thirty three patients were enrolled consecutively. Using a questionnaire, data on social demographic characteristics, the clinical features of patients diagnosed with IBS using Rome III criteria and clinical patterns of IBS were collected. Results: The prevalence of IBS among patients attending the GI outpatient clinic in Mulago hospital was found to be 9.3% using Rome III criteria. The commonest type of IBS was found to be the untyped IBS (IBS – U) occurring among 11 (35.5%) patients of those diagnosed with IBS. This was closely followed by the IBS-A with alternating diarrhoea and constipation 10 (32.3%). Diarrhoea predominant IBS (IBS-D) and constipation predominant IBS (IBS-C) was found to be less common with 5 (9.7%) and 5 (9.7%) respectively. In this study, it was found that there was significant association between IBS and patients coming from the central region of Uganda (OR=0.33, 95% CI=0.14-0.79, p=0.009). Conclusions and recommendations: The prevalence of IBS among patients attending the GI outpatient clinic was found to be 9.3% using Rome III criteria. The commonest type of IBS was found to be the untyped IBS (IBS – U) occurring 11 (35.5%) of those diagnosed with IBS. This was followed by the alternate type of IBS (IBS-A) 10 (32.3%). Diarrhoea predominant IBS (IBS-D) and constipation predominant IBS (IBS-C) was found to be less common 5 (9.7%). In this study, it was found that there was a significant association between IBS and patients coming from the central region of Uganda. We recommend that clinicians should have high index of suspicion for IBS and the GI clinic should be equipped with medication for the various types of IBS amongst other illnesses