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Association of irritable bowel syndrome with depression, anxiety, stress, and sociodemographic factors in Saudi Arabia: a cross-sectional survey

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  • 24% of respondents (373/1,553) met Rome IV criteria for IBS in Saudi Arabia in this online cross-sectional survey.
  • IBS symptoms were associated with significantly higher self-reported depression, anxiety, and stress scores on the DASS-21.
  • Most IBS cases reported moderate lifestyle impact; subtype distribution: 44.5% IBS-D, 34.6% IBS-C, 20.9% IBS-M.
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Front Public Health. 2026 Aug 7;14:1866985. doi: 10.3389/fpubh.2026.1866985. eCollection 2026.

ABSTRACT

BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional bowel disease and a common cause of gastroenterological referrals. This cross-sectional survey estimated the prevalence of Rome IV-defined IBS symptoms among adults residing in Saudi Arabia and examined their associations with sociodemographic characteristics, and self-reported symptoms of depression, anxiety, and stress.

METHODOLOGY: A cross-sectional online survey was conducted from August 2024 to March 2025 among adults aged 18 years or above residing in the five regions of Saudi Arabia. It was coordinated by the Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia. Participants were recruited through electronic platforms, and data were collected using a self-administered questionnaire that included sociodemographic variables, Rome IV symptom questions with the Bristol Stool Form Scale, and Arabic version of the Depression, Anxiety, and Stress Scale-21 (DASS-21).

RESULTS: A total of 1,553 participants completed the survey. Overall, 373 participants (24%) met the Rome IV symptom-based criteria for IBS. Participants with IBS symptoms had significantly higher mean DASS-21 depression, anxiety, and stress scores than participants without IBS symptoms. IBS symptoms were more common among participants aged 25-50 years, married, living in the Eastern region, and individuals with master’s degrees. Among participants who met the Rome IV criteria, all reported recurrent abdominal pain at least once weekly over the past 3 months, and 255 (68.4%) reported that their abdominal pain was always related to time of defecation. A large number of participants (322, 86.3%) who met the Rome IV symptom-based criteria for IBS reported a moderate impact of IBS on their lifestyle. Based on the Bristol Stool Form Scale, 166 participants (44.5%) were classified as IBS-D (diarrhea), 129 (34.6%) as IBS-C (constipation), and 78 (20.9%) as IBS-M (mixed). In multivariable logistic regression, age, education level, and depression, anxiety, and stress symptom categories were statistically associated with IBS symptoms.

CONCLUSION: In this online cross-sectional survey, 24% of respondents met symptom-based Rome IV criteria for IBS. IBS symptoms were associated with higher self-reported depression, anxiety, and stress scores and selected sociodemographic factors. Longitudinal and clinical studies are needed to clarify temporality and inform integrated gastrointestinal and psychological care.

PMID:42630152 | PMC:PMC13493239 | DOI:10.3389/fpubh.2026.1866985

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