Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome

J. Y. Chang, A. E. Almazar, G. Richard Locke, J. J. Larson, E. J. Atkinson, N. J. Talley, Yuri Ann Saito Loftus

Research output: Contribution to journalArticle

Abstract

Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, diagnosed on symptom-based criteria. Many have reported discrepancies between formal Rome criteria and diagnoses made in clinical practice. The aim of the study was to explore whether a quantitative version of the Rome criteria would better represent a clinical diagnosis of IBS than the current dichotomous criteria for symptom measure. Methods: As part of a large, case-control study, participants completed a validated bowel disease questionnaire. Rome criteria were analyzed based on 15 individual symptoms. Penalized logistic regression model with stepwise selection was used to identify significant symptoms of IBS which were independently associated with case-control status. Key Results: In cases with a clinical diagnosis of IBS, 347 (70%) met Rome criteria for IBS. Increasing number of Rome symptoms were found related to the odds of being diagnosed with IBS. Nearly half of the Rome-negative case group experienced infrequent symptoms suggesting milder disease. Five of 15 Rome symptoms were associated with predicting case-control status in the final model, with 96% correctly classified among Rome-positive cases, 76% for Rome-negative cases, and 91% for controls. Conclusions and Inferences: Irritable bowel syndrome appears to be a spectrum disorder. Quantifying individual symptoms of Rome criteria has greater utility than the current application in representing the degree of IBS affectedness and appears to better reflect a clinical diagnosis of IBS applied by physicians. The use of a quantitative diagnostic Rome “score” may be helpful in clinical practice and research studies to better reflect the degree an individual is affected with IBS.

Original languageEnglish (US)
Article numbere13356
JournalNeurogastroenterology and Motility
Volume30
Issue number9
DOIs
StatePublished - Sep 1 2018

Fingerprint

Irritable Bowel Syndrome
Logistic Models
Gastrointestinal Diseases
Case-Control Studies
Physicians

Keywords

  • diagnostic criteria
  • irritable bowel syndrome
  • Rome criteria

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

Chang, J. Y., Almazar, A. E., Richard Locke, G., Larson, J. J., Atkinson, E. J., Talley, N. J., & Saito Loftus, Y. A. (2018). Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome. Neurogastroenterology and Motility, 30(9), [e13356]. https://doi.org/10.1111/nmo.13356

Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome. / Chang, J. Y.; Almazar, A. E.; Richard Locke, G.; Larson, J. J.; Atkinson, E. J.; Talley, N. J.; Saito Loftus, Yuri Ann.

In: Neurogastroenterology and Motility, Vol. 30, No. 9, e13356, 01.09.2018.

Research output: Contribution to journalArticle

Chang, JY, Almazar, AE, Richard Locke, G, Larson, JJ, Atkinson, EJ, Talley, NJ & Saito Loftus, YA 2018, 'Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome', Neurogastroenterology and Motility, vol. 30, no. 9, e13356. https://doi.org/10.1111/nmo.13356
Chang JY, Almazar AE, Richard Locke G, Larson JJ, Atkinson EJ, Talley NJ et al. Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome. Neurogastroenterology and Motility. 2018 Sep 1;30(9). e13356. https://doi.org/10.1111/nmo.13356
Chang, J. Y. ; Almazar, A. E. ; Richard Locke, G. ; Larson, J. J. ; Atkinson, E. J. ; Talley, N. J. ; Saito Loftus, Yuri Ann. / Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome. In: Neurogastroenterology and Motility. 2018 ; Vol. 30, No. 9.
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abstract = "Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, diagnosed on symptom-based criteria. Many have reported discrepancies between formal Rome criteria and diagnoses made in clinical practice. The aim of the study was to explore whether a quantitative version of the Rome criteria would better represent a clinical diagnosis of IBS than the current dichotomous criteria for symptom measure. Methods: As part of a large, case-control study, participants completed a validated bowel disease questionnaire. Rome criteria were analyzed based on 15 individual symptoms. Penalized logistic regression model with stepwise selection was used to identify significant symptoms of IBS which were independently associated with case-control status. Key Results: In cases with a clinical diagnosis of IBS, 347 (70{\%}) met Rome criteria for IBS. Increasing number of Rome symptoms were found related to the odds of being diagnosed with IBS. Nearly half of the Rome-negative case group experienced infrequent symptoms suggesting milder disease. Five of 15 Rome symptoms were associated with predicting case-control status in the final model, with 96{\%} correctly classified among Rome-positive cases, 76{\%} for Rome-negative cases, and 91{\%} for controls. Conclusions and Inferences: Irritable bowel syndrome appears to be a spectrum disorder. Quantifying individual symptoms of Rome criteria has greater utility than the current application in representing the degree of IBS affectedness and appears to better reflect a clinical diagnosis of IBS applied by physicians. The use of a quantitative diagnostic Rome “score” may be helpful in clinical practice and research studies to better reflect the degree an individual is affected with IBS.",
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