Disclosures: Goodoory reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
May 10, 2021
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Rome IV IBS linked to more severe symptoms

Disclosures: Goodoory reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Patients with Rome IV irritable bowel syndrome had more severe symptoms with negative implications on quality of life compared with patients with Rome III IBS, according to research published in Clinical Gastroenterology and Hepatology.

“IBS is a common disorder of gut-brain interaction and the latest revision of the Rome criteria used for the diagnosis of IBS, the Rome IV criteria, were published in 2016. The aim was to increase their specificity over prior iterations. In doing so, they have become more restrictive and prior studies have demonstrated that individuals who meet Rome IV criteria for IBS have more severe gastrointestinal symptoms and exhibit higher levels of psychological co-morbidity than those with Rome III-defined IBS,” Vivek C. Goodoory, MBChB, Leeds Institute of Medical Research at St. James, University of Leeds, told Healio. “We conducted this study to examine if these differences are consistent over time and whether they affect the natural history of IBS.”

“Individuals with Rome IV IBS had more severe GI and psychological symptoms which had greater impact on activities of daily living.” Vivek C. Goodoory, MBChB

In a longitudinal follow-up study, researchers examined 1,0997 adults with IBS meeting the Rome III and Rome IV criteria. They collected and compared data regarding symptom severity and impact, consultation behavior, treatment plans and psychological health; researchers further analyzed the differences in subsequent disease behaviors.

At 12-months, researchers followed-up with 452 patients who met Rome IV criteria and 186 patients who met Rome III criteria. Compared with patients with Rome III IBS, patients with Rome IV IBS were more likely to have seen a primary care physician (44.7% vs. 28.5%) or a gastroenterologist (26.3% vs. 12.4%) for their symptoms, commenced a new treatment (73% vs. 60.2%) as well as cycled through more treatments. Researchers noted patients with Rome IV IBS also reported more severe symptoms and exhibited higher proportions of poor psychological health.

“Individuals with Rome IV IBS had more severe gastrointestinal and psychological symptoms, which in turn had greater impact on activities of daily living at 12-month follow-up compared to those with Rome III IBS,” Goodoory said. “This has important implications for future research as the therapeutic gain of therapies may be smaller over placebo and difficult to compare with most treatment trials, which have been conducted using Rome III criteria.”