Gut-Brain Connection; IBS linked to Anxiety, Quality of Life, and Academic Performance in Undergraduate Students
Mohamed Sadeq Al-Ibrahim *1, Ahmad Hamdy Ibrahim 2, Sawsan S. Al- Rawi *3, Bayram Dawod Ahmed 4, Nalan Linda Fraim 5
Journal of Angiotherapy 8(1) 1-10 https://doi.org/10.25163/angiotherapy.819418
Submitted: 05 December 2023 Revised: 19 December 2023 Published: 08 January 2024
Abstract
Background: Irritable bowel syndrome (IBS) is a disease that affects the lower gastrointestinal tract. It causes several distressing abdominal symptoms that affect the quality of life, emotional well-being, and academic performance of undergraduate students. Chronic stress affects many processes including immunity and angiogenesis. Our cross-sectional study aimed to identify the prevalence of IBS and its impact on anxiety levels, quality of life, and academic performance among undergraduate students. Method: A total of 357 students (male and female) were randomly selected. IBS prevalence was assessed using Rome III criteria and Birmingham IBS Symptom Questionnaire. Anxiety and quality of life were measured using Beck Anxiety Inventory and IBS-Quality of Life Questionnaire respectively. Results: About 16% of students had IBS with the majority from medical departments. Females had a higher IBS prevalence due to diet, lifestyle, and cultural habits. Students with IBS showed high levels of anxiety, below-average quality of life, low academic performance, and insufficient knowledge of IBS. Interestingly, negative, and positive correlations (p =.000) were found between the demographic variables. However, the anxiety levels and quality of life were significantly correlated. Conclusion: Several factors, such as social characteristics, diet, and posttraumatic stress disorder caused by wars, are significantly correlated with IBS development, and could impact students' lives. Our findings can pave the way for creating preventive measures, including stress management and health education programs, to curb the incidence of IBS and anxiety among undergraduate students. Therefore, appropriate interventions are necessary to address the student’s mental health with IBS and improve their academic and personal lives.
Keywords: Irritable Bowel Syndrome, Anxiety, Academic performance, mental health, Quality-of-Life, Undergraduate
References
AlButaysh OF, AlQuraini AA, Almukhaitah AA, Alahmdi YM, Alharbi FS. (20200. Epidemiology of irritable bowel syndrome and its associated factors in Saudi undergraduate students. Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association. 26(2):89.
Al-Rawi SS, Ibrahim AH, Ahmed G B. (2023). Unraveling the Link Between Lymphopenia and Systemic Lupus Erythematosus: Implications for Disease Severity and Potential Treatment Strategies. Eurasian Journal of Science and Engineering. 9(2).
Al-Rawi SS, Ibrahim AH. (2023)a. Uncovering the Smoking Habits of Undergraduate University Students: A Comprehensive Assessment of Different Varieties of Tobacco Use. Journal of Population Therapeutics and Clinical Pharmacology. 25; 30(9): e248–e257; DOI: 10.47750/jptcp.2023.30.09.025.
Al-Rawi, S., & H Ibrahim, A. (2023) b. The Overlooked Risk Behaviors of Hepatitis B Virus among Medical and Nonmedical Undergraduate Students. Acta Biomedica, 94(2).
Al-Rawi, S.S., Jumah, H.A., Ibrahim, A.H., Hamdy, H.A., Hama, H.A., Dogara, A.M. and Effendi, A.B.A. (2021). Depression, Anxiety and Stress Level among University Students of Class Reentry Post Covid-19 Pandemic. International Journal of Social Sciences and Educational Studies, 9(2), p.14.
Ashraf Al-Hadethe, Nigel Hunt, Shirley Thomas & Abdulgaffar Al-Qaysi (2014). Prevalence of traumatic events and PTSD symptoms among secondary school students in Baghdad, European Journal of Psychotraumatology, 5:1, DOI: 10.3402/ejpt.v5.23928.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology. 6, 893.
Carco C, Young W, Gearry RB, Talley NJ, McNabb WC, Roy NC. (2020). Increasing evidence that irritable bowel syndrome and functional gastrointestinal disorders have a microbial pathogenesis. Frontiers in cellular and infection microbiology. 9; 10:468.
Chen, H. H., Hung, C. H., Kao, A. W., & Hsieh, H. F. (2021). Exploring quality of life, stress, and risk factors associated with irritable bowel syndrome for female university students in Taiwan. International Journal of Environmental Research and Public Health. 18(8), 3888.
Cozma-Petrut A, Loghin F, Miere D, Dumitrascu DL. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients! World journal of gastroenterology. 6;23(21):3771.
Dale HF, Lorentzen SC, Mellin-Olsen T, Valeur J. (2023). Diet-microbiota interaction in irritable bowel syndrome: looking beyond the low-FODMAP approach. Scandinavian Journal of Gastroenterology. 28:1-2.
Darabi, Zahra; Mokari-Yamchi, Amin; Hajizadehoghaz, Masoomeh; and Rezazadeh, Arezoo. (2019). "Diets and Irritable Bowel Syndrome". Nutrition and Health Sciences -- Faculty Publications. 201. https://digitalcommons.unl.edu/nutritionfacpub/201
Das, A., Razon, A. H., Ahmad, T., & Paul, D. K. (2022). Prevalence of irritable bowel syndrome and its associated risk factors among university students of Bangladesh. JGH Open..
Dimidi E, Whelan K. (2020). Food supplements and diet as treatment options in irritable bowel syndrome. Neurogastroenterology & Motility. 32(8): e13951.
Drossman, D. A., Patrick, D. L., Whitehead, W. E., Toner, B. B., Diamant, N. E., Hu, Y., & Bangdiwala, S. I. (2000). Further validation of the IBS-QOL: a disease-specific quality-of-life questionnaire. The American Journal of Gastroenterology. 4, 999-1007.
El Sharawy, S.M., Amer, I.F. and Elkadeem, M.Z. (2022). Irritable bowel syndrome in Egyptian medical students, prevalence, and associated factors: a cross-sectional study. The Pan African Medical Journal. 41.
Elhosseiny D, Mahmoud NE, Manzour AF. (2019). Factors associated with irritable bowel syndrome among medical students at Ain Shams University. Journal of the Egyptian Public Health Association. 94(1):1-9.
El-Salhy M. (2015). Recent developments in the pathophysiology of irritable bowel syndrome. World J Gastroenterol. 21:7621–36.
El-Salhy, M., Patcharatrakul, T., & Gonlachanvit, S. (2021). The role of diet in pathophysiology and management of irritable bowel syndrome. Indian Journal of Gastroenterology; 40(2), 111-119.
Frändemark Å, Törnblom H, Jakobsson S, Simrén M. (2018). Work productivity and activity impairment in irritable bowel syndrome (IBS): a multifaceted problem. Official journal of the American College of Gastroenterology| ACG. 1;113(10):1540-9.
Grover M, Kolla BP, Pamarthy R, Mansukhani MP, Breen-Lyles M, He JP, Merikangas KR. (2021). Psychological, physical, and sleep comorbidities and functional impairment in irritable bowel syndrome: Results from a national survey of US adults. PloS one. 14;16(1): e0245323.
Gulewitsch, M. D., Enck, P., Hautzinger, M., & Schlarb, A. A. (2011). Irritable bowel syndrome symptoms among German students: Prevalence, characteristics, and associations to somatic complaints, sleep, quality of life, and childhood abdominal pain. European Journal of Gastroenterology & Hepatology. 4, 311-316.
Ibrahim AH, Dahham SS, Al-Muffti SA, Al-Rawi SS. (2018). Obesity Study among Secondary School Students at Duhok City. In IOP Conference Series: Materials Science and Engineering. 454, 1,012165. IOP Publishing.
Jia W, Liang H, Wang L, Sun M, Xie X, Gao J, Li L, Tang X, Ma Y. (2022). Associations between Abnormal Eating Styles, and irritable bowel syndrome: A Cross-Sectional Study among Medical School Students. Nutrients. 9;14(14):2828.
Kim O, Cha C, Jeong H, Cho M, Kim B. (2021). Influence of Irritable Bowel Syndrome on Stress and Depressive Symptoms in Nurses: The Korea Nurses’ Health Study. International Journal of Environmental Research and Public Health. 24;18(23):12324.
Kim YS, Kim N. (2018). Sex-gender differences in irritable bowel syndrome. Journal of neurogastroenterology and motility. 24(4):544.
Kopczynska M, Mokros L, Pietras T, Malecka-Panas E. (2018). Quality of life and depression in patients with irritable bowel syndrome. Prz Gastroenterol. 13(2):102-108. doi: 10.5114/pg.2018.75819. Epub 2018 May 16. PMID: 30002768; PMCID: PMC6040097.
Liu H, Zou Y, Kan Y, Li X, Zhang Y. (2022). Prevalence, and Influencing Factors 1of Irritable Bowel Syndrome in Medical Staff: A Meta-Analysis. Digestive Diseases and Sciences. 17:1-0.
Lu, Y., Zhao, H., Liu, Y., Zuo, Y., Xu, Q., Liu, L., ... & Li, Y. (2021). Chronic stress activates plexinA1/VEGFR2-JAK2-STAT3 in vascular endothelial cells to promote angiogenesis. Frontiers in Oncology, 11, 709057.
Menees SB, Maneerattannaporn M, Kim HM, Chey WD. (2012). The efficacy and safety of rifaximin for the irritable bowel syndrome: a systematic review and meta-analysis. Official journal of the American College of Gastroenterology| ACG. 1;107(1):28-35.
Ministry of Health/Iraq. (2012). Central organization for statistics and information technology; in collaboration with WHO/Iraq. Iraqi Family Health Survey Report, 2006; 11-30. Ministry of Health/Iraq. Annual Report. http://www.moh.gov.iq/arabic/index.php.
Ministry of Human Rights/Iraq. (2011). The impact of terrorism on human rights; Human Affairs Victims of Terrorism Security. 14-41
Naeem, S. S., Siddiqui, E. U., Kazi, A. N., Memon, A. A., Khan, S. T., & Ahmed, B. (2012). Prevalence, and factors associated with irritable bowel syndrome among medical students of Karachi, Pakistan: a cross-sectional study. Biomedical Center Research Notes. 5(1), 255-258.
Nehar Tayseer, Al Zubaidi Abdelqawi. (2009). The psychometric properties of the Arabic version of beck anxiety inventory in United Arab Emirates, Journal of the Educational Research Center. 18, 87-106.
Okami Y, Kato T, Nin G, Harada K, Aoi W, Wada S, Higashi A, Okuyama Y, Takakuwa S, Ichikawa H, Kanazawa M. (2011). Lifestyle, and psychological factors related to irritable bowel syndrome in nursing and medical school students. Journal of gastroenterology. 46(12):1403-10.
Patrick, D. L., Drossman, D. A., & Frederick, I. O. (1997). A quality-of-life measure for persons irritable bowel syndrome (IBS-QOL): User’s manual and scoring diskette for United States Version. Seattle, Washington: University of Washington. 5-45.
Pickett-Blakely O. (2014). Obesity and irritable bowel syndrome: a comprehensive review. Gastroenterology & hepatology. 10(7):411.
Qureshi SR, Abdelaal AM, Janjua ZA, Alasmari HA, Obad AS, Alamodi A, Shareef MA. (2016). Irritable bowel syndrome: a global challenge among medical students. Cureus. 1;8(8).
Rej, A., Aziz, I., Tornblom, H., Sanders, D. S., & Simrén, M. (2019). The role of diet in irritable bowel syndrome: implications for dietary advice. Journal of internal medicine, 286(5), 490-502.
Saha, L. (2014). Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World Journal of Gastroenterology: WJG. 20(22), 6759.
Schmulson, Max, and Miguel Saps. (2018). Irritable bowel syndrome: from young to older age. NeuroGastroLatam Rev. 2:133-148.
Seger, S., Nasharuddin, N. N. B., Fernandez, S. L., Yunus, S. R. B. M., Shun, N. T. M., Agarwal, P., & Burud, I. (2020). Prevalence, and factors associated with irritable bowel syndrome among medical students in a Malaysian private university: a cross sectional study. The Pan African Medical Journal. 37.
Shulman RJ, Jarrett ME, Cain KC, Broussard EK, Heitkemper MM. (2014). Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome. Journal of gastroenterology. 49(11):1467-76.
Soliman M T, Qalawa S A. (2022). Association Between Psychological Upset and Irritable Bowel Syndrome Among Nursing Students At KSA. International Journal of Health Services Research and Policy. 7(2):195-208.
Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Revue d'epidemiologie et de sante publique, 67(5), 295-301. Syndrome. Journal of Gastrointestin and Liver Diseases. (4), 357-362.
Spiller, R., Aziz, Q., Creed, F., Emmanuel, A., Houghton, L., Hungin, P., & Whorwell, P. (2007). Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut. 56(12), 1770-1798.
Varjú P, Farkas N, Hegyi P, Garami A, Szabó I, Illés A, Solymár M, Vincze Á, Balaskó M, Pár G, Bajor J. (2017). Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies. PloS one. 14;12(8):0182942.
Vasquez-Rios, G., Machicado, J. D., Ticse, R., Ruiz, E. F., Gamero, M. T., Pezua, A., ... & Tagle, M. (2019). Stress and a sedentary lifestyle are associated with irritable bowel syndrome in medical students from Peru: a cross-sectional study. European journal of gastroenterology & hepatology. 31(11), 1322-1327.
Velasco-Corrada, P., Amill, R. R., & Torres, E. (2019). Prevalence of Irritable Bowel Syndrome Among Medical Students of Puerto Rico. Official journal of the American College of Gastroenterology| ACG. 114, S1578-S1579.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. The Lancet. 20;370(9596):1453-7.
Wani, F. A., Almaeen, A. H., Bandy, A. H., Thirunavukkarsu, A., Al-Sayer, T. A., Flah, A., ... & Albalawi, M. M. (2020). Prevalence and risk factors of IBS among medical and nonmedical students in the Journal of University. Niger j Clin pract. 23(4), 555-60.
Weaver KR, Melkus GD, Henderson WA. Irritable bowel syndrome: a review. (2017). The American journal of nursing. 117(6):48.
Weber HC. Irritable bowel syndrome and diet. (2022). Current Opinion in Endocrinology & Diabetes and Obesity. 1;29(2):200-6.
Yang, W., Yang, X., Cai, X., Zhou, Z., Yao, H., Song, X., ... & Xiong, P. (2022). The Prevalence of Irritable Bowel Syndrome Among Chinese University Students: A Systematic Review and Meta-Analysis. Frontiers in public health. 777.
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