More than 25% of adults in the United States, Canada and United Kingdom fit the Rome IV criteria for at least one of the six functional bowel disorders, according to study results.
Olafur S. Palsson, PsyD, from the division of gastroenterology and hepatology at the University of North Carolina at Chapel Hill, and colleagues wrote that almost no national population data are available on the prevalence of these disorders, making it difficult to get a full picture of their impact.
“These disorders are a set of overlapping and interactive symptoms and it is well recognized, as emphasized by the Rome IV bowel disorders working team, that they often transition over time in the same individual,” they wrote. “Therefore, examining their collective presence in the population as a group gives a better idea of functional health problems in the lower GI tract than merely focusing on individual diagnoses.”
Rome IV criteria included the five functional bowel disorders (FBD) that were also part of Rome III — irritable bowel syndrome, functional constipation, functional diarrhea, functional abdominal bloating/distension, and unspecified bowel disorder — and added opioid-induced constipation. The main changes to the classifications were the definitions to IBD and functional diarrhea.
Researchers analyzed data from a survey of adults in the U.S., U.K. and Canada comprising 5,931 individuals (49.2% women, mean age 47.4 years). The survey included the Rome IV Diagnostic Questionnaire, Rome II IBS and constipation questions and the SF-8 quality of life questionnaire.
Palsson and colleagues found that the prevalence of FBDs were similar across the three countries, falling between 28.6% and 31.7%. They determined the range for each disorder, including IBS (4.4%–4.8%), functional constipation (7.9%–8.6%), functional diarrhea (3.6%–5.3%), functional bloating (2%–3.9%), OIC (1.1%–1.9%) and unspecified FBD (7.5%–10%).
Prevalence of IBS was cut in half by Rome IV criteria compared with Rome III, which the authors attributed to a higher minimum pain frequency in Rome IV. However, the updated criteria resulted in higher prevalence for functional constipation and functional diarrhea.
“These results provide illustrations of the prevalence impact of changes introduced by Rome IV in IBS and functional diarrhea that may prove useful for guiding future development of the Rome criteria,” Palsson and colleagues wrote. – by Alex Young
Disclosure: The authors report no relevant financial disclosures.