A prospective comparison of UK and Malaysian patients with irritable bowel syndrome in secondary care

Aliment Pharmacol Ther. 2023 Jul;58(2):168-174. doi: 10.1111/apt.17567. Epub 2023 Jun 1.


Kee-Huat Chuah 1Christopher J Black 2 3Vincent Tee 4Sze-Zee Lim 1Wen-Xuan Hian 1Nur-Fazimah Sahran 4Yeong-Yeh Lee 4Sanjiv Mahadeva 1Alexander C Ford 2 3


Author information

1Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

2Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.

3Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

4School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.


Background: The prevalence of irritable bowel syndrome (IBS) is now known to be similar in various geographical regions, but there has been no study directly comparing characteristics of patients with IBS between populations.

Aims: To evaluate clinical and psychological differences between adults with IBS seen in secondary care in the United Kingdom (UK) and Malaysia.

Methods: Age- and sex-matched patients with IBS from a single centre in the UK (Leeds) and two centres in Malaysia (Kuala Lumpur and Kota Bharu), who fulfilled Rome III criteria, were recruited prospectively. Demographic characteristics and gastrointestinal and psychological symptoms were compared between both groups.

Results: A total of 266 (133 UK and 133 Malaysian) age- and sex-matched patients with Rome III IBS were recruited (mean age: 45.1 years Malaysia, vs. 46.5 years UK; 57.9% female). UK patients were more likely to consume alcohol than Malaysian patients (54.1% vs. 10.5%, p < 0.001). Compared with Malaysian patients, UK patients had more frequent abdominal pain, abdominal bloating, meal-related symptoms (p < 0.001 for all), higher symptom scores (mean 268.0 vs 166.0; p < 0.001), greater limitation of activities due to IBS (p = 0.007) and were more likely to report abnormal anxiety scores (p < 0.001). Higher perceived stress (mean 21.3 vs. 19.1, p = 0.014) and gastrointestinal symptom-specific anxiety scores (mean 50.8 vs. 43.0, p < 0.001) were also observed in UK patients. Finally, UK patients had higher somatoform symptom-reporting scores (mean 8.9 vs. 6.9, p < 0.001).

Conclusions: IBS is more severe and is associated with a higher level of psychological symptoms in the UK compared with Malaysian patients in secondary care.

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