How the Change in IBS Criteria From Rome III to Rome IV Impacts on Clinical Characteristics and Key Pathophysiological Factors
How the Change in IBS Criteria From Rome III to Rome IV Impacts on Clinical Characteristics and Key Pathophysiological Factors
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DOI：
10.1038/s41395-018-0074-z
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发表时间：
2018-07-01
影响因子：
9.8
通讯作者：
Simren, Magnus
中科院分区：
文献类型：
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作者：
Aziz, Imran;Tornblom, Hans;Simren, Magnus
目的：肠易激综合征（IBS）的诊断标准最近从Rome III更新到Rome IV。在Rome III中，IBS的诊断需要每月至少3天的慢性腹痛或不适，而在Rome IV中，不适一词已被删除，腹痛的频率增加到每周至少1天。我们研究了肠易激综合征标准的变化对临床特征和病理生理因素的影响。方法：共有542名患有罗马III型IBS的瑞典受试者完成了一份基线问卷，询问他们在过去10天内腹痛天数；随后，该指标被用作识别Rome IV型IBS的替代指标，其中(a)疼痛持续0天或1天的患者被归类为Rome IV阴性，(b)疼痛持续>= 2天的患者被归类为Rome IV阳性。比较罗马iv阳性和阴性肠易激综合征组的人口统计学、肠易激综合征亚型、胃肠道和心理症状、躯体化、疲劳、疾病特异性生活质量、直肠敏感性和口-肛运输时间。结果：总体而言，85%的罗马III型IBS患者符合罗马IV型IBS标准，但15%没有。与罗马iv阴性受试者相比，罗马iv阳性受试者明显更有可能是女性，生活质量较差，疼痛程度更严重，腹胀，躯体化，疲劳和直肠敏感。在焦虑或抑郁的严重程度、IBS亚型、排便习惯不满意或口肛运输时间方面没有差异。最后，疼痛天数的增加与症状和内脏过敏呈正相关。结论：大多数寻求医疗保健的罗马iii型阳性IBS患者符合罗马IV型IBS标准。他们构成了比那些失去肠易激综合征诊断的人更严重的群体。
OBJECTIVES: The diagnostic criteria for irritable bowel syndrome (IBS) have recently been updated from Rome III to Rome IV. Whereas in Rome III a diagnosis of IBS entailed chronic abdominal pain or discomfort at least 3 days per month, in Rome IV the term discomfort has been removed and the frequency of abdominal pain increased to at least 1 day per week. We examined how this change in IBS criteria impacts on clinical characteristics and pathophysiological factors.METHODS: A total of 542 Swedish subjects with Rome III IBS completed a baseline questionnaire enquiring for the number of abdominal pain days in the last 10 days; this was subsequently used as a surrogate marker to identify Rome IV IBS, in that (a) those with 0 or 1 day of pain were classed as Rome IV-negative, and (b) those with >= 2 days of pain were classed as Rome IV-positive. Comparisons were made between Rome IV-positive and -negative IBS groups for demographics, IBS subtype, gastrointestinal and psychological symptoms, somatisation, fatigue, disease-specific quality of life, rectal sensitivity, and oro-anal transit time.RESULTS: Overall, 85% of Rome III IBS patients fulfilled the Rome IV criteria for IBS, but 15% did not. Rome IV-positive subjects were significantly more likely to be female, have poorer quality of life, greater pain severity, bloating, somatisation, fatigue, and rectal sensitivity than Rome IV-negative subjects. There were no differences in severity of anxiety or depression, IBS subtypes, bowel habit dissatisfaction, or oro-anal transit time. Finally, increasing number of pain days correlated positively with symptoms and visceral hypersensitivity.CONCLUSIONS: Most Rome III-positive IBS patients seeking healthcare fulfil the Rome IV IBS criteria. They constitute a more severe group than those who lose their IBS diagnosis.