Authors: Hassan Abdulkarim Alsulaiman , Abbas Mohammed Almusawi , Qusai Adnan Alobaid , Hassan Ali Almubarak , Hussain Sadeq Alsemaeel , Alhassan Mohammed Bujubarah , Mohammed Hussain Alamer , Mohammed Khalid Al-Alwan , Kumail Mohammed Al Abdullah , Ali Abdulla Alnahwi , Mohammed Yousef Alessa ,

Abstract

Background: Irritable bowel syndrome (IBS) is a common chronic gastrointestinal condition that significantly affects quality of life and imposes a considerable economic burden. Despite the availability of ROME IV diagnostic criteria, gaps in PHC physician knowledge and practice have been reported. PHC physicians play a central role in the diagnosis, management, and follow-up of patients with IBS, making their awareness and application of ROME IV criteria critical.

Methods: A descriptive cross-sectional study was conducted among PHC physicians in Al-Ahsa, Saudi Arabia, between June 2025 and September 2025. A structured, self-administered questionnaire adapted from a previously validated tool was used to assess knowledge, attitudes, and practices regarding IBS and ROME IV criteria.

Results: A total of 99 physicians participated, most of whom were aged ≤40 years (95.0%), with residents (40.4%) and general practitioners (32.3%) forming the majority. Awareness of ROME IV criteria was high, with 89.9% reporting familiarity and 82.8% having used them previously; however, only 29.3% applied them routinely for all cases, while 56.6% used them only in selected cases. Knowledge gaps were identified regarding the required diagnostic timelines, with only half correctly identifying the 3-month symptom fulfillment criterion and approximately one-fifth reporting uncertainty. Although 65.7% believed the ROME criteria were effective for diagnosing IBS, continuity of care was inconsistent, with 69.7% reporting they could only sometimes maintain follow-up.

Conclusion: These findings highlight the need for improved physician education and stronger adherence to standardized diagnostic criteria to optimize IBS management in primary care.

Keywords: Irritable bowel syndrome, Rome IV criteria, knowledge, attitudes, and practices, primary health care, Al-Ahsa, Saudi Arabia.