Irritable bowel syndrome: An international study of symptoms in eight countries

Charles D. Gerson, Mary Joan Gerson, Richard A. Awad, Abhijit Chowdhury, Christine Dancey, Pierre Poitras, Piero Porcelli, Ami Sperber, Wei An Wang

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    30 Scopus citations


    Objectives: This report is a preliminary comparative study of irritable bowel syndrome symptoms in eight countries, USA, Mexico, Canada, England, Italy, Israel, India, and China. We also assessed global symptom patterns and correlations and relationships to several psychosocial variables. Methods: Two hundred and thirty-nine participants completed a bowel symptom scale composed of four symptoms, abdominal pain or discomfort, bloating, diarrhea, and constipation as well as two psychosocial questionnaires, quality of relationship and attribution of symptoms to physical or emotional factors. Results: Pain score in Italy, with the least urban population, was significantly higher than six of the seven other countries whereas it was lowest in India and England. Bloating was highest in Italy and constipation was highest in Mexico, both significantly higher than five other countries. Diarrhea was higher in China than five other countries. All significance values were P < 0.05. Globally, diarrhea was less common than constipation, P<0.001 and bloating significantly correlated with constipation as well with pain, P<0.05. Composite analysis of psychosocial variables and symptoms indicated that family conflict correlated directly, P<0.05, whereas family support correlated indirectly, P<0.01, with pain and bloating. Pain, bloating and diarrhea were significantly attributed to physical etiology, P<0.01, whereas only diarrhea was attributed to emotional cause, P<0.05. Conclusion: This study suggests that there are significant variations in irritable bowel syndrome symptoms in different geographic locations around the world. Various hypotheses that may explain our data such as cultural beliefs, gut contamination, urban and rural location, dietary practice, and psychosocial factors should be further investigated.

    Original languageEnglish
    Pages (from-to)659-667
    Number of pages9
    JournalEuropean Journal of Gastroenterology and Hepatology
    Issue number7
    StatePublished - 1 Jul 2008


    • Cross-cultural
    • International
    • Irritable bowel syndrome
    • Irritable bowel syndrome symptoms
    • Mind-body


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