Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice

Simrén, Magnus; Palsson, Olafur S.; Whitehead, William E.

doi:10.1007/s11894-017-0554-0

Cited by 213 publications

(164 citation statements)

References 40 publications

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“…15 Recently, an expert working group has incorporated criteria for OIC into Rome IV diagnostic criteria for colorectal disorders. 16,17 Rome IV diagnostic criteria include new or worsening of such symptoms as low frequency of spontaneous bowel movements (SBMs), straining during defecation, a sense of incomplete evacuation and/or anorectal blockage, and hard or lumpy stool consistency after the initiation of opioids. 16 Patient-provider communications are crucial for the diagnosis of OIC, which is often made only if a patient communicates with the HCP about constipation after initiating opioid therapy.…”

Section: Introductionmentioning

confidence: 99%

Patients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective Observational Cohort Study of Japanese Patients With Cancer

Fumita

Imai²,

Harada

et al. 2020

Journal of Pain and Symptom Management

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Context. Many patients who have cancer consider opioid-induced constipation (OIC) to be a burdensome side effect of opioid treatment.Objectives. To evaluate patient-reported outcomes in Japanese patients with cancer pain and OIC.Methods. This prospective observational study evaluated OIC incidence for two weeks in patients with cancer after they initiated strong opioid therapy. Rome IV diagnostic criteria, a physician's diagnosis, spontaneous bowel movements, Bowel Function Index score, and patients' daily self-assessments were used. Changes from baseline in Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life (PAC-QOL) scores were compared between patients with and without OIC. Patients and health care providers (HCPs) completed study-specific questionnaires regarding OIC burden, treatment satisfaction, and patient-provider communications.Results. Among 212 enrolled patients, the incidence of OIC was 47.6% by patients' self-assessments, with a cumulative incidence of 30.2% by Day 3 and 43.5% by Day 7. Patient Assessment of Constipation Symptoms and PAC-QOL overall scores from patients with OIC worsened significantly from baseline compared with patients without OIC by all diagnostic criteria, except for spontaneous bowel movement frequency for PAC-QOL. Patients and HCPs were generally satisfied with OIC treatment; however, 53.5% of patients and approximately 40.0% of HCPs reported that OIC affected pain management. Most patients and HCPs reported that OIC conditions were sufficiently or essentially communicated.Conclusion. After starting opioid therapy, patients recognized OIC onset and its impact on cancer pain management, highlighting the need for effective patient-provider communications, diagnosis, and treatment of OIC to improve QOL for patients with cancer receiving opioid analgesics. J Pain Symptom Manage 2020;59:1043e1051. Ó This article reports patients' self-assessment data from a prospective observational cohort study that evaluated the incidence of OIC in Japanese patients with cancer. The results indicate that patient recognition of OIC occurs rapidly after opioid initiation, and OIC has a negative impact on health-related QOL.

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Section: Introductionmentioning

confidence: 99%

Patients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective Observational Cohort Study of Japanese Patients With Cancer

Fumita

Imai²,

Harada

et al. 2020

Journal of Pain and Symptom Management

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“…Before diagnosing IBS, warning signs and possible disorders that can mimic IBS should be ruled out [5]. Before the introduction of Rome criteria, which form an expert consensus for diagnosing functional gastrointestinal disorders-first released in 1990 and updated periodically [43]-Manning criteria were used for the diagnosis of IBS [44]. According to the Manning criteria, IBS is diagnosed when any four of six symptoms related with abdominal pain or bowel movement are present [44].…”

Section: Discussionmentioning

confidence: 99%

The Association between Helicobacter pylori Infection and Irritable Bowel Syndrome: A Meta-Analysis

Kim

Cho

Kwak

2020

IJERPH

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The association of Helicobacter pylori (H. pylori) infection with functional dyspepsia has been well studied. However, the data on the relationship between H. pylori infection and irritable bowel syndrome (IBS) are conflicting. This study aims to elucidate the association between H. pylori infection and IBS. PubMed, Cochrane Library, CINAHL and SCOPUS databases were searched to identify eligible English articles published up to December 2019. Cross-sectional studies, case-control studies and cohort studies reporting both prevalence of H. pylori infection and IBS were selected for the detailed review. The pooled odds ratio (ORs) and their 95% confidence interval (CI) were calculated. A total of 7269 individuals in four cross-sectional studies and six case-control studies were included. The prevalence of H. pylori infection ranged from 12.8% to 73.4% in the control group, and 9.7% to 72.1% in the IBS group. The combined OR for H. pylori infection was 1.10 (95% CI: 0.93-1.29, I 2 : 37.5%). In a subgroup analysis of IBS defined according to Rome criteria, the OR for H. pylori infection was 1.10 (95% CI: 0.93-1.30, I 2 = 31.7%). In this meta-analysis, H. pylori infection was not significantly associated with IBS. Well-designed studies are needed to identify the relationship between H. pylori infection and IBS.

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“…A likely reason for the varying incidence of OIC is the use of several diagnostic criteria for reporting OIC in clinical trials and cross‐sectional studies, including the frequency of bowel movements (BMs), physician assessments, and the Bowel Function Index (BFI) . Recently, researchers have incorporated criteria for OIC into the Rome IV criteria for colorectal disorders (see Materials and Methods) . Briefly, the Rome IV diagnostic criteria include key new or worsening symptoms of OIC such as low frequency of spontaneous bowel movements (SBMs), straining during defecation, a sense of incomplete evacuation and/or anorectal blockage, and hard or lumpy stool consistency .…”

Section: Introductionmentioning

confidence: 99%

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

et al. 2019

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This multicenter, prospective, observational cohort study assessed opioid induced constipation (OIC) in Japanese patients with cancer. Eligible patients had stable cancer and an ECOG PS of 0‐2. OIC incidence based on the Rome IV diagnostic criteria was determined by patient diary entries during the first 14 days of opioid therapy. The proportion of patients with OIC was calculated for each 1‐week period and the overall 2‐week study period. Secondary measurements of OIC included the Bowel Function Index (BFI) score (patient assessment administered by physician), spontaneous bowel movements (SBMs) per week (patient assessment), and physician assessments. Medication for constipation was allowed. Two hundred and twenty patients were enrolled. The mean morphine‐equivalent dose was 22 mg/day. By Rome IV criteria, the cumulative incidence of OIC was 56% (95% CI: 49.2%‐62.9%); week 1, 48% (95% CI: 40.8%‐54.6%); week 2, 37% (95% CI: 30.1%‐43.9%). The cumulative incidence of OIC was lower in patients who received prophylactic agents for constipation (48% [95% CI: 38.1%‐57.5%]) than in patients who did not (65% [95% CI: 55.0%‐74.2%]). The cumulative incidences of OIC were 59% (95% CI: 51.9%‐66.0%), 61% (95% CI: 54.3%‐68.1%), and 45% (95% CI: 38.0%‐51.8%) based on BFI scores, physician assessments, and SBM frequency, respectively. Frequency of BMs/week before starting opioids was the most influential factor for the occurrence of OIC. Utilization of prophylactic agents for constipation was associated with a modest effect on reducing the incidence of OIC. The incidences of OIC reported were variable depending on the diagnostic tool involved.

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Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice

Cited by 213 publications

References 40 publications

Patients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective Observational Cohort Study of Japanese Patients With Cancer

Patients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective Observational Cohort Study of Japanese Patients With Cancer

The Association between Helicobacter pylori Infection and Irritable Bowel Syndrome: A Meta-Analysis

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

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