Characterising irritable bowel syndrome : an exploratory cross-sectional study

Abstract

Background: Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder influenced by cultural, dietary and psychosocial factors. Locally relevant tools are needed to better understand the experiences and management behaviours of Maltese individuals living with IBS. Objective: To develop and content-validate a culturally relevant questionnaire and characterise a sample of Maltese patients living with Irritable Bowel Syndrome (IBS). Methodology: A cross-sectional quantitative design was used. Consenting Maltese adults meeting the Rome IV criteria for IBS were recruited via social media and outpatient gastroenterology and dietetic clinics across Malta. A 30-item culturally adapted questionnaire was systematically developed, content-validated and administered. Collected variables included demographics, lifestyle behaviours, psychological comorbidities, symptom severity, diagnosis status, information sources, dietary triggers and treatments used. Descriptive statistics summarised cohort characteristics, while inferential analyses examined associations between symptom severity and demographic or clinical variables (p < 0.05), with effect sizes calculated. Results: The sample (N = 130) was predominantly female (90.8%), most commonly aged 36 - 45 years, with a mean BMI of 27.5 ± 6.8 kg/m². Participants reported moderate symptom severity and high rates of psychological comorbidities. Food was the most frequently reported trigger (78.5%), particularly dairy (45%) and vegetables, fruit, beans and legumes (39%). Pharmacological treatments were widely used (85.4%) and online sources were the predominant information channel (80.8%). No significant associations were identified between symptom severity and demographic or clinical factors. Conclusion: This study describes a symptom-aware Maltese cohort actively engaging in IBS self-management. The prominence of food-related triggers, moderate symptom severity and psychological comorbidities underscores the need for multidisciplinary, personalised, evidence-based care, including dietetic and psychological support. The validated questionnaire offers a culturally grounded tool for future research and clinical assessment in Malta.