The youth are the cornerstone of the society whose academic achievements contribute to the progress of any nation7, thus university students were our targeted sample size.
The concept of quality of life (QoL) is used to express the general wellness of a person or a group of people, therefore it can be considered a reflection of happiness8.
The aim of this study is to measure and compare quality of life in different Egyptian university students and to find the prevalence of irritable bowel syndrome among university students and the relation of IBS to QoL.
This study included 656 university students, of whom 365 students (55.6%) completed the QoL questionnaire with all of its dimensions, 202 of them (55.3%) were medical students and 163 were non-medical students (44.7%) (table 1).
Our study proved that QoL of Faculty of Medicine students were significantly lower than QoL of students in Faculty of Education in all dimensions (P value = < 0.001) (table 2).
This in concordance with Noreen et al. 2021 who found that non-medical students scored significantly higher QoL scores in comparison with medical students (P value = < 0.05)9.
Pagnin and De Queiroz 2015 found that medical students exhibited poorer psychological well-being and social relationships than age-matched young people in the general population. They had a lower QoL in comparison to young general population with a significant proportion of the students had a low quality of life in all domains10.
In contrast to our findings, a study by Latas et al. 2014 found that medical students in comparison to the non-medical group had significantly higher scores11.
Also, Henning et al. 2012 results showed that medical students perceived their QoL as better or equivalent to other non-medical students' group12.
That may be due to the varied study population and ethnicities.
In our present study, 196 students were females (53.7%) and 169 students were males (46.3%). We found that male students had statistically significant higher scores in the health dimension, personality dimension and in the total QoL scores (p value = < 0.001). Males also had higher scores in the external standard dimension but the difference was statistically insignificant (p value = 0.235) (table 3).
In agreement with our results, Latas et al. 2014 found that male students generally perceive their QoL as better than females11. Also, Messina et al. 2016 reported that female students obtained lower scores of SF-36 than males8.
Contrary to our study, Noreen et al. 2021 found that female students significantly scored high on QoL compared to male students (p < 0.05), while male students scored higher on psychological distress (p < 0.05)9.
Furthermore, Acheampong et al. 2017 documented that there was no significant difference in quality of life scores for male and female pharmacy students in University of Ghana13.
Those negative results might be attributed to the psychological distress males develop as they are expected to bear greater responsibility of the future for their families in particular and society in general. Also many of male students had to work during university years especially those in the middle and low socioeconomic class which could have a negative impact on their mental and physical health.
In the present study, ages of the students ranged from 18 to 26. Our results showed a statistically significantly higher health dimension, personality dimension, external dimension and total QoL scores in younger (≤ 21 years) vs. older (> 21 years) (p = < 0.001) (table 4).
That in concordance with, Raj et al. 200014 and Sabbah et al. 201315.
Opposite findings were reported by Pitil et al. 2020 who found that older students had better QoL16 and Nur et al. 2017 who found no statistically significant difference between the older and younger groups17.
That may be due to different society cultures.
We found that 353 (96.7%) of the students were single while only 12 (3.3%) students were married. There was no statistically significant difference in health dimension, personality dimension, external dimension and total QoL scores in single vs. married students in the four universities (p value = 0.165). That might be due to the very low number of married students in general in our sample size (table 5).
Out of the 365 students who completed the QoL survey, 325 students were IBS free while 40 students had IBS according to ROME IV criteria with a prevalence of 11% among university students (table 1), that in agreement with AlButaysh et al. 2020 who estimated IBS prevalence in the university students of the Kingdom of Saudi Arabia at 15.8%18. Nearly the same result was found in a Chinese study that reported a prevalence of 15.7% among Chinese university students19.
Also in agreement with our study, a German study revealed that IBS prevalence among university students was 18.1%20. In the Lebanese study by Costanian et al. 2015 IBS prevalence was estimated at 20%21. Close results were found in an Iranian study conducted at Ahvaz Jundishapur University of Medical Sciences22 and an Egyptian study done at Suez Canal University23 that found IBS prevalences among students were 21.1% and 22.9% respectively.
That in contrast to Goyal et al. 202124 and Dong et al., 201025 whose results were 6.2% and 7.85% respectively. That would be due to the difference in faculties included in the survey, varied study population and different diagnostic criteria applied (the latter study used Rome III criteria for IBS diagnosis).
Our study revealed that 28 students had IBS among medical students with a Prevalence of 13.86%, while only 12 students had IBS among non-medical students with a Prevalence of 7.36%. We found that prevalence of IBS among medical students was significantly higher than in non-medical students (p = 0.048) (table 6).
In agreement with the present study, AlButaysh et al. 2020 stated that IBS was reported to be higher among medical students (31.9%) than among students of other colleges (8.8%)18. Another study conducted in Saudi Arabia showed significantly higher prevalence of IBS among medical students (42.2%) versus non-medical students (16.4%) in Jouf University26.
In contrast with our study, Jafri et al. 2005 found a higher frequency of IBS in non-medical college students in Pakistan (41% vs. 26%)27, While an Egyptian study conducted in Suez Canal University reported that 23.8% of the students in the Faculty of Commerce English section had IBS, whereas 22.1% of the students in the Faculty of Medicine were diseased23.
This might be because of IBS being not only highly affected by stress, but also by the unhealthy eating habits that non-medical students may not be aware of.
In our study, 29 female students reported to have IBS with a prevalence of 14.8%, whilst 11 male students reported to have IBS with a prevalence of 6.5%. This showed a significant higher prevalence of IBS in female students than in male students (p value = 0.011) (table 6).
In concordance with the present study, Ghanaei et al. 2009 found that IBS was more prevalent in females than males (15% vs. 8.1%)28. AlButaysh et al. 2020 reported the same result with a percentage of 20.5% in females and 9.8% in males18.
The Egyptian study by Darweesh et al. 2015 demonstrated that IBS prevalence in female students was nearly 3 times the prevalence in males as 30.3% of the female students had IBS and only 9.8% of the male students had the disease23.
In contrast, Seger et al. 2020 found that male students were more affected by IBS with a prevalence of 16.9% versus 13.1% of female students that had the disease29.
Likewise, Wani et al. 2020 reported that IBS was more prevalent in the male students when compared to female students with a statistically significant relationship (P = 0.039) with a prevalence of 38.7% in males and 16% in females26.
Those results indicating higher prevalence of IBS in males might be caused by increased expectations from family and society, family commitments, stressful education, and inability to handle the stress. Cultural factors might also limit females from reporting having the disease.
In our present study, we found a significant correlation between age and prevalence of IBS, as the median age of non-IBS students was 21 (18–26) while the median age of IBS students was 23 (19–25). IBS prevalence was significantly higher in older students than in younger ones (p value = < 0.001) (table 6).
This is in agreement with our study, Govindaraja et al. 2018 found that IBS was more common in students who were or more than 22 years old30, also Alaqeel et al. 2017 reported the same results31.
In contrast to our study, Costanian et al. 201521 and Ghanaei et al. 200928 documented that IBS prevalence was higher among students who aged ≤ 22 years than older students who aged > 22 years.
Those results might be due to improved adaptation of a lot of older students to the symptoms or due to becoming aware of managing the symptoms by medication.
We also found that 39 single students had IBS (97.5%) and only 1 married student had the disease (2.5%). The correlation between marital status and having IBS was statistically insignificant. That might be due to the very low number of married students in general in our sample size (table 6).
Our results showed that there was no statistically significant differences in IBS prevalence in the four universities (Mansoura, Alexandria, Port Said and Assuit) (p value = 0.121) (table 6).
In the present study, we investigated the QoL in the non-IBS and IBS students and found that IBS group had statistically significant lower QoL (p value = 0.039) (table 6).
In agreement with our results, Dong et al. 201025 and Kesuma et al. 202132.