ABSTRACT
AIM: To survey irritable bowel syndrome (IBS) using Rome III criteria among Malays from the north-eastern region of Peninsular Malaysia. METHODS: A previously validated Malay language Rome III IBS diagnostic questionnaire was used in the current study. A prospective sample of 232 Malay subjects (80% power) was initially screened. Using a stratified random sampling strategy, a total of 221 Malay subjects (112 subjects in a "full time job" and 109 subjects in "no full time job") were recruited. Subjects were visitors (friends and relatives) within the hospital compound and were representative of the local community. Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires. Subjects with IBS were sub-typed into constipation-predominant, diarrhea-predominant, mixed type and un-subtyped. Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS. RESULTS: IBS was present in 10.9% (24/221), red flags in 22.2% (49/221) and psychosocial alarm features in 9.0% (20/221). Red flags were more commonly reported in subjects with IBS (83.3%) than psychosocial alarm features (20.8%, P < 0.001). Subjects with IBS were older (mean age 41.4 years vs 36.9 years, P = 0.08), but no difference in gender was noted (P = 0.4). Using univariable analysis, IBS was significantly associated with a tertiary education, high individual income above RM1000, married status, ex-smoker and the presence of red flags (all P < 0.05). In multiple logistic regression analysis, only the presence of red flags was significantly associated with IBS (odds ratio: 0.02, 95%CI: 0.004-0.1, P < 0.001). The commonest IBS sub-type was mixed type (58.3%), followed by constipation-predominant (20.8%), diarrhea-predominant (16.7%) and un-subtyped (4.2%). Four of 13 Malay females (30.8%) with IBS also had menstrual pain. Most subjects with IBS had at least one red flag (70.8%), 12.5% had two red flags and 16.7% with no red flags. The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS. CONCLUSION: Using the Rome III criteria, IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.
Subject(s)
Asian People/statistics & numerical data , Irritable Bowel Syndrome/diagnosis , Irritable Bowel Syndrome/ethnology , Surveys and Questionnaires , Adult , Asian People/psychology , Constipation/diagnosis , Constipation/ethnology , Diarrhea/diagnosis , Diarrhea/ethnology , Female , Health Care Surveys , Humans , Irritable Bowel Syndrome/psychology , Logistic Models , Malaysia/epidemiology , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Predictive Value of Tests , Prevalence , Prospective Studies , Psychometrics , Risk Factors , Young AdultABSTRACT
BACKGROUND AND AIM: The Malay language is widely used within the "Malay Archipelago" particularly in Malaysia, Indonesia, Philippines, Singapore and Brunei with a combined population of 300 million. There are no reliable data on the epidemiology of irritable bowel syndrome (IBS) in the Malay speaking population because the Rome Diagnostic Questionnaire has not been translated and validated for the Malay language. The current study aimed to translate and validate the Rome III IBS Diagnostic Questionnaire, Red Flag and Psychosocial Alarm questionnaires into the Malay language. METHODS: Forward and backward translations of the source questionnaires were performed according to guidelines from the Rome foundation. The Malay translated questionnaires were assessed for clarity in a group of 10 volunteers. Psychometric properties of the questionnaires were assessed in 31 subjects with IBS based on Rome II symptom criteria and 31 healthy controls prospectively. Test-retest reliability was assessed using intra-class correlation (ICC) over a 14-day interval. The sensitivity and specificity of the IBS diagnostic module for distinguishing IBS patients from controls was tested. RESULTS: The ICC for the IBS module was 0.996 (95% confidence interval 0.991-0.998) with good discriminant validity (P < 0.001). ICCs for the Red Flags and Psychosocial Alarm questionnaires were 0.962 and 0.994 respectively. The sensitivity, specificity and positive predictive value of the translated Rome III IBS module against Rome II criteria was 80.65%, 100% and 100%, respectively. CONCLUSION: The translated Malay language Rome III IBS Diagnostic Questionnaire and the questionnaires for Red Flags and Psychosocial Alarm symptoms are valid and reliable.
