Kee-Huat Chuah1, Keng-Hau Beh2, Nurul Azmi Mahammad Rappek3, Sanjiv Mahadeva1. 1. Gastroenterology and Hepatology Unit, Department of Medicine, University of Malaya. 2. Department of Medicine, University of Malaya. 3. Staff and Student Health clinic, University Malaya Medical Centre.
Abstract
BACKGROUND: The Rome IV criteria has been suggested to alter functional gastrointestinal disorder (FGID) characteristics of patients in referral centres. Its' impact in a primary care setting is less well known. METHOD: A cross-sectional study of consecutive adults in a primary healthcare setting was conducted. Differences in frequency, epidemiology, healthcare utilisation and health-related quality of life(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: A total of 1002 subjects were recruited. The frequency of common FGIDs was 20.7% (n = 207) and 20.9% (n = 209) amongst subjects based on the Rome III and Rome IV criteria. The frequency of IBS reduced from 4% (Rome III) to 0.8% (Rome IV), whilst the frequency 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). The majority of the Rome III IBS subjects (52.5%, n = 21) which 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 significantly more healthcare utilization and lower HRQOL compared to non-FGID controls. CONCLUSION: The Rome IV criteria significantly alters 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 utilization and HRQOL. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: The Rome IV criteria has been suggested to alter functional gastrointestinal disorder (FGID) characteristics of patients in referral centres. Its' impact in a primary care setting is less well known. METHOD: A cross-sectional study of consecutive adults in a primary healthcare setting was conducted. Differences in frequency, epidemiology, healthcare utilisation and health-related quality of life(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: A total of 1002 subjects were recruited. The frequency of common FGIDs was 20.7% (n = 207) and 20.9% (n = 209) amongst subjects based on the Rome III and Rome IV criteria. The frequency of IBS reduced from 4% (Rome III) to 0.8% (Rome IV), whilst the frequency 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). The majority of the Rome III IBS subjects (52.5%, n = 21) which 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 significantly more healthcare utilization and lower HRQOL compared to non-FGID controls. CONCLUSION: The Rome IV criteria significantly alters 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 utilization and HRQOL. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.