Rates of functional bowel disorders among Israeli Bedouins in rural areas compared with those who moved to permanent towns

Background & Aims: Half of Israeli Bedouin society has undergone a transition from nomadic existence to permanent towns, causing cultural and social upheaval. The aim was to compare rates of irritable bowel syndrome (IBS) and functional bowel disorders (FBDs) between Israeli Bedouins still living under rural conditions with those in permanent towns. Methods: Interviews were conducted in Arabic by trained Bedouin interviewers at 8 Bedouin clinics. The same interviewers surveyed the 2 sectors under identical sampling and interviewing conditions at the same time. FBDs were diagnosed by Rome II criteria. Results: One thousand seven hundred fifty-five Bedouins participated, 1018 from permanent towns and 737 from rural areas. Sixty percent were female (58.2% for rural and 62.0% for towns). The mean age was 39.1 ± 14.1 years (39.0 ± 14.3 years for towns, 39.2 ± 13.9 years for rural; P = NS). The mean level of education was 4.3 ± 5.4 years (4.6 ± 5.6 years for towns, 3.7 ± 5.2 years for rural; P <. 0001). IBS was diagnosed in 9.4% of town and 5.8% of rural Bedouins (P <. 01). In contrast, rural Bedouins had significantly higher rates of functional abdominal bloating (7.9% vs 2.8%, P <. 0001) and a marginally higher rate of functional constipation. Bedouins living in towns attributed their gastrointestinal symptoms to stress more than rural Bedouins did (P <. 05). Stress and poor global feeling of well-being were significant contributors for IBS in logistic regression models for both sectors. Conclusions: Bedouins living in permanents towns have significantly higher rates of IBS than rural Bedouins. Although these findings might be associated with the stressful social upheaval that they have undergone, further study is needed to substantiate this point.