The Transition From Rome III to Rome IV Irritable Bowel Syndrome: What We Gain and Lose.
The Transition From Rome III to Rome IV Irritable Bowel Syndrome: What We Gain and Lose.
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从罗马 III 到罗马 IV 肠易激综合症的转变：我们得到和失去的。
DOI：
10.1016/j.cgh.2021.06.032
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Chang,Lin
中科院分区：
文献类型：
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作者：
Shin,Andrea;Chang,Lin
在一项纵向调查研究中，Goodory等人。1比较罗马IV标准定义的肠易激综合征(IBS)患者的自然病史2和其前身罗马III定义的IBS患者的自然病史。3先前的横断面研究表明，罗马标准的这两次不同迭代定义的患者群体不同。目前这项研究的作者此前表明，符合罗马IV标准的IBS患者的症状比那些只符合罗马III标准的患者更严重。4这些观察结果并不出人意料，因为罗马四标准从罗马三标准被修改，将腹痛阈值从每月至少三天提高到每周一天，这是基于普通人口症状频率的第90个百分位数。5此外，删除了腹部不适一词。Goodory等人。基于先前的观察，证明这些差异是持久的，并转化为在12个月期间罗马IV定义的IBS患者更高的医疗利用率、更高的症状严重性和更差的心理健康。在他们的分析中，属于罗马四组的大多数人既符合罗马四号标准，也符合罗马三号标准。相反，罗马III组只包括那些符合罗马III标准的人，但不包括罗马IV组。然而，应该承认的是，结果是，研究比较了在疼痛严重程度或频率方面得到丰富的罗马III组(即罗马IV标准)和那些疼痛频率较高的较不严重的罗马III组。只有17名患者符合罗马四号标准，但没有满足罗马三号标准，即改变语言，明确疼痛症状可能与排便有关，而不是随着排便而改善，且缺乏腹部不适要求的总体影响相对较小。这些发现与之前的研究结果一致，这些研究表明，在满足罗马三号和罗马四号方面的大部分差异是由于腹痛频率阈值的变化。5.尽管本研究报告的结论信息类似，
In a longitudinal survey study, Goodoory et al. 1 compared the natural history of individuals with irritable bowel syndrome (IBS) defined by Rome IV criteria2 and those defined by their predecessor, Rome III. 3 Prior cross-sectional studies have demonstrated that the patient populations defined by these two separate iterations of the Rome criteria differ. The authors of the current study previously showed that patients with IBS who met Rome IV criteria had more severe symptoms than those who only met Rome III criteria. 4 These observations were not unexpected as the Rome IV criteria were modified from Rome III to increase the abdominal pain threshold from at least 3 days per month to one day per week based on the 90th percentile for symptom frequencies among the general population. 5 In addition, the term abdominal discomfort was removed. Goodoory et al. built on prior observations to demonstrate that these differences were durable and translated into higher healthcare utilization, increased symptom severity, and poorer psychological health in patients with Rome IV-defined IBS over a 12-month period. In their analysis, most individuals belonging to the Rome IV group satisfied both Rome IV and III criteria. Conversely, the Rome III group included only those who met Rome III criteria, but not Rome IV. However, it should be acknowledged that as a consequence, the study compared a Rome III group that had been enriched for pain severity or frequency (ie Rome IV criteria) and a less severe Rome III group in which those with higher pain frequencies were effectively removed. Only 17 patients satisfied Rome IV criteria without satisfying Rome III to imply that changing the language to specify that pain symptoms could be “related to” rather than “improved with” defecation and the lack of the abdominal discomfort requirement had a relatively minimal overall impact. These findings are consistent with the results of previous studies that showed that most of the difference in meeting Rome III vs Rome IV was due to the change in the frequency threshold for abdominal pain. 5 Although the concluding message of the current study is similar,