Association Between Ethnicity and Treatment Preferences in Patients with Irritable Bowel Syndrome

Vered Richter, Efrat Broide, Tzippora Shalem, Daniel L. Cohen, Tawfik Khoury, Atallah Mansour, Timna Naftali, and Amir Mari

Abstract

Background and Aims: Irritable bowel syndrome (IBS) poses a significant healthcare challenge, characterized by chronic gastrointestinal and extraintestinal symptoms impacting individuals’ well-being. Treatment preferences may vary among patients from different ethnic groups, such as Arab and Jewish Israelis, necessitating tailored approaches.

Methods: A bilingual (Hebrew/Arabic) questionnaire assessing patients’ preferences regarding treatment goals was developed. It was administered online in Israeli IBS Facebook groups, as well as in two hospital gastroenterology clinics.

Results: The study included 267 IBS patients (91 Arabs and 176 Jews). Demographic analysis revealed a higher proportion of females in both groups, with a significantly greater percentage among Jews compared to Arabs (84% versus 64.8%, respectively, P<0.001). The median age was 32 years for both Arabs and Jews (interquartile ranges of 26–42 and 24–62, respectively). Arabs exhibited higher rates of mixed-type IBS and constipation, while Jews had a higher prevalence of predominant diarrhea IBS. Arabs reported more bloating, higher rates of IBS-related comorbidities, and more medication usage. When asked to rate the importance of treatment goals, both populations preferred improvement in abdominal pain, bloating, and regular defecation, while assigning lower importance to improving difficulty in mental and/or physical aspects of intercourse, as well as arthralgia and myalgia. Arab patients assigned lower importance scores to various symptoms compared to their Jewish counterparts.

Conclusion: This study highlights the impact of ethnicity on patients’ treatment goals. Understanding patients’ preferences will enable tailoring an individual approach to each IBS patient.

Rambam Maimonides Med J 2025;16(2):e0007