Brief Article
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World J Gastroenterol. Oct 14, 2013; 19(38): 6465-6471
Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6465
Consumption of spicy foods and the prevalence of irritable bowel syndrome
Ahmad Esmaillzadeh, Ammar Hassanzadeh Keshteli, Maryam Hajishafiee, Awat Feizi, Christine Feinle-Bisset, Peyman Adibi
Ahmad Esmaillzadeh, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Ahmad Esmaillzadeh, Maryam Hajishafiee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Ammar Hassanzadeh Keshteli, Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
Awat Feizi, Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
Christine Feinle-Bisset, Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide Discipline of Medicine, Adelaide, South Australia 5000, Australia
Peyman Adibi, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan 81745-319, Iran
Peyman Adibi, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan 81745-319, Iran
Author contributions: Esmaillzadeh A, Keshteli AH and Adibi P contributed to conception, design, data collection, statistical analysis and drafting of the manuscript; Hajishafiee M, Feizi A and Feinle-Bisset C contributed to data interpretation and manuscript drafting; all authors approved the final version for submission.
Supported by A grant from Isfahan University of Medical Sciences, Isfahan, Iran; A Senior Research Fellowship from the National Health and Medical Research Council of Australia (NHMRC Grant No. 627002, 2010 - 2014) to Feinle-Bisset C
Correspondence to: Peyman Adibi, Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Hezarjarib Street, Isfahan 81745-319, Iran. adibi@med.mui.ac.ir
Telephone: +98-311-7923060 Fax: +98-311-6687898
Received: May 22, 2013
Revised: July 28, 2013
Accepted: August 16, 2013
Published online: October 14, 2013
Processing time: 145 Days and 22.1 Hours
Abstract

AIM: To explore the association between consumption of spicy foods and prevalence of irritable bowel syndrome (IBS) among Iranian adults.

METHODS: In this cross-sectional study, data from 4763 Iranian adult participants were used. Consumption of spicy foods was estimated using a dietary habits questionnaire that included a question on spicy foods consumption: “how frequently do you use spicy foods (pepper, curry, ginger, cinnamon and turmeric) during a week?” Participants could respond to the question by choosing one of these choices: never, 1-3 times, 4-6 times, 7-9 times, or more than 10 times per week. A modified Persian version of the Rome III questionnaire was used to determine the prevalence of IBS.

RESULTS: IBS was prevalent in 21.7% (18.6% of men and 24.1% of women) of the study population. After controlling for potential confounders including dietary behaviors, those consuming spicy foods ≥ 10 times per week were 92% more likely to have IBS compared with those who never consumed spicy foods (OR = 1.92; 95%CI: 1.23-3.01, Ptrend < 0.01). The association remained significant even after taking lactose intolerance into account (OR = 1.85; 95%CI: 1.18-2.90, Ptrend < 0.01). Stratified analysis by gender revealed that the association between consumption of spicy foods and IBS was not significant in men; however, a significant association was found among women after taking potential cofounders, including meal regularity and lactose intolerance, into account. Women who consumed spicy foods ≥ 10 times per week were two times more likely to have IBS compared with those who never consumed spicy foods (OR = 2.03; 95%CI: 1.09-3.77, Ptrend = 0.02).

CONCLUSION: Consumption of spicy foods is directly associated with IBS, particularly in women. Further, prospective studies are warranted to (1) examine this association in other populations; and (2) evaluate whether dietary interventions, for example a reduction in spice consumption, would improve IBS symptoms.

Keywords: Spice; Diet; Condiments; Red pepper; Irritable bowel syndrome; Functional gastrointestinal disorders

Core tip: The role of dietary habits, including consumption of spicy foods, in the development of functional gastrointestinal disorders remains controversial. In this cross-sectional study in a large sample of Iranian adults, we found that women with high consumption of spicy foods had a two-fold increased risk of developing irritable bowel syndrome compared with women who reported not to consume spicy foods. The results underline the need for further studies to characterize potential relationships between diet-related practices and the risk of functional gastrointestinal disorders, in order to design appropriate, and effective, diet-based interventions.