METHODS: Articles published in PubMed, MEDLINE, CINAHL and Science Direct from 2005 to 2015 were searched systematically. Studies were included if constipation satisfied the Rome II and or III criteria. Study populations consisted of Asian adults above 18 years old and with sample size above 50.
RESULTS: Of 2812 articles screened, 11 met the eligibility criteria. Constipation among Asian adults was characterized by three core symptoms of 'straining' at 82.8%, 'lumpy and hard stool' at 74.2% and 'sensation of incomplete evacuation' at 68.1% and the least frequent symptom was 'manual maneuver to facilitate defecation' at 23.3%. There was heterogeneity in frequency patterns of core symptoms between different Asian studies but also differences in core symptoms between constipation subtypes of functional constipation and irritable bowel syndrome with constipation.
CONCLUSIONS: In general, Asian adults perceive constipation symptoms in a similar but not equivalent manner to the West. Recognition of core symptoms will increase the diagnostic confidence of constipation and its subtypes but more studies of the various specific Asian populations are needed to address their differences.
RECENT FINDINGS: Disordered immune reactions and release of cytokines with resultant gut inflammation and dysfunction appear to be key features of PI-IBS. Disordered brain-gut-microbiota interactions, type of infecting agent, and host-genetic susceptibility are risk factors but also are reasons for the varying spectrum of clinical severity. Although prognosis is generally good, symptoms and inflammation may persist for a long time. Symptomatic relief with antidiarrheals, antispasmodics, 5HT3 antagonists, mesalamine, probiotics, and low-dose antidepressants remain the primary approaches, but in some difficult cases, a combination of drugs that target the pathophysiology may be helpful. PI-IBS has many overlapping features with IBS-D and shares similar pathophysiology and management approaches.
Methods: a cross sectional study was conducted among the medical students from semester 6 to semester 9 (year 3, year 4 and year 5) of a Malaysian private university. The questionnaire consisted of 2 main sections. Section A was on demographic data and section B consisted of the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the Rome IV Questionnaire for IBS. Association between the factors gathered and IBS was assessed using the Chi-Square test. Variables with a p-value of less than 0.2 in the univariate analysis were entered into a multivariate analysis model.
Results: number of students who responded were 190 (56.3%) were females, 66.3% were Chinese and 37.9% were from semester 9. Twenty-eight (14.7%) students had symptoms consistent with a diagnosis of IBS. Depression was found to be significantly associated with IBS (adjusted OR: 4.749, CI: 1.809-12.470).
Conclusion: this study suggests that IBS is common among Malaysian medical students. There was a significant association between IBS and depression.