Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6788
Peer-review started: June 26, 2017
First decision: July 27, 2017
Revised: August 23, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: October 7, 2017
Processing time: 96 Days and 19.5 Hours
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients’ quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
Core tip: The epidemiology, clinical presentation and management of irritable bowel syndrome (IBS) may vary in different geographical regions due to differences in diet, gastrointestinal infection and infestations, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Asia is geographically and socio-demographically diverse. In this context, India, Bangladesh and Malaysia share some similarities: (1) large population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review aims to explore clinical and epidemiological data on IBS from these three major nations in South and South-East Asia.