The epidemiology and quality of life of functional gastrointestinal disorders according to Rome III vs Rome IV criteria: A cross‐sectional study in primary care

Abstract

Objective: To explore the differences in frequency and epidemiology of functional gastrointestinal disorders (FGIDs) in a primary care setting, and to examine the health-related quality of life (HRQOL) and healthcare utilization of FGID patients based on the Rome III and Rome IV criteria. Methods: A cross-sectional study of consecutive adults in a primary healthcare setting was conducted. Differences in epidemiology, and HRQOL of common FGIDs (functional dyspepsia [FD], irritable bowel syndrome [IBS], functional diarrhea, functional constipation [FC]) between the Rome III and IV criteria were explored. Results: Among a total of 1002 subjects recruited, the frequency of common FGIDs was 20.7% and 20.9% among subjects based on the Rome III and Rome IV criteria, respectively. The frequency of IBS reduced from 4.0% (Rome III) to 0.8% (Rome IV), while that of functional diarrhea increased from 1.2% (Rome III) to 3.3% (Rome IV). In contrast, there was no significant change in the frequency of FD (7.5% [Rome III] vs 7.6% [Rome IV]) and FC (10.5% [Rome III] vs 11.7% [Rome IV]). Most of the Rome III IBS subjects (52.5%, n = 21) who did not meet Rome IV IBS criteria, fulfilled the criteria for FC, functional diarrhea, FD, or overlap syndrome. Subjects with all FGIDs, regardless of criteria, had more healthcare utilization and lower HRQOL compared to non-FGID controls. Conclusions: The Rome IV criteria alter the frequency of IBS and functional diarrhea, but not FD and FC, when compared to the Rome III criteria. Regardless of criteria, FGIDs had a significant impact on healthcare burden and HRQOL.

Prevalence, clinical characteristics, and management of irritable bowel syndrome in Vietnam: A scoping review

“…Similar finding has been recently reported in Malaysia, a neighboring country. 27 The WGO global guidelines and the Asian consensus suggest that in patients with concerning features (i.e. age of onset >50 years, family history of colorectal cancer [CRC], blood in stools, unexplained weight loss, loss of appetite, nocturnal symptoms, fever, anemia, abdominal mass, and ascites), there should be prompt initiation of investigationsincluding colonoscopy.…”

Functional dyspepsia leads to more healthcare utilization in secondary care compared with other functional gastrointestinal disorders

“…1,8,9 A recent primary care-based study highlighted an increased rate of clinical consultation, consumption of GI medication and a lower HRQoL among patients with common FGIDs, including FD, IBS, functional constipation (FC) and functional diarrhea, compared with those without FGIDs. 10 So far, data for healthcare utilization of FGIDs in secondary care is still lacking. A U.S. nationwide database analysis of patients with chronic GI and liver diseases revealed that the hospitalization burden and cost in patients with FGIDs were similar to those of patients with inflammatory bowel diseases or chronic liver diseases in secondary care.…”

The challenges of implementing evidence‐based therapy for irritable bowel syndrome in Asia

“…1 Studies in primary and secondary care in Asia have shown that IBS is common among adults who consult for their symptoms. 3 Although it does not affect mortality, IBS in Asia has been shown to have a significant impact on patients' quality of life and also increases the healthcare burden. 1,3 The impact of IBS can be reduced by implementing appropriate, evidence-based therapy in this condition.…”

“…3 Although it does not affect mortality, IBS in Asia has been shown to have a significant impact on patients' quality of life and also increases the healthcare burden. 1,3 The impact of IBS can be reduced by implementing appropriate, evidence-based therapy in this condition. The latest British Society of Gastroenterology guidelines and the recent Asian Consensus on IBS advocate the establishment of an effective doctor-patient relationship as the key to a successful management of IBS.…”

“…With urbanization, the prevalence of IBS in Asia has increased, with a prevalence rate of 1.5 to 4.1% with the latest Rome IV criteria 1 . Studies in primary and secondary care in Asia have shown that IBS is common among adults who consult for their symptoms 3 . Although it does not affect mortality, IBS in Asia has been shown to have a significant impact on patients' quality of life and also increases the healthcare burden 1,3 …”