Key result
ROME III detects ~12% fewer functional GI disorders than ROME II in eating disorder inpatients.
Why the study?
The prevalence and predictors of functional gastrointestinal disorders in eating disorder patients using ROME III criteria compared to ROME II criteria were unclear.
Does the ROME III criteria compared to ROME II alter the prevalence and predictors of functional gastrointestinal disorders in female eating disorder inpatients?
Cohort (n=260)
Does the ROME III criteria compared to ROME II alter the prevalence and predictors of functional gastrointestinal disorders in female eating disorder inpatients?
The ROME III criteria alters the distribution of functional gastrointestinal disorders compared to ROME II in eating disorder patients, with starvation and somatisation being significant predictors of specific FGIDs.
Answers are grounded in this paper and cite their sources.
ROME III yields lower FGID prevalence than ROME II in eating disorder inpatients; leaves open criteria effects on assessment and research comparability.
AIM: To compare the prevalence of Functional gastrointestinal disorders (FGIDs) using ROME III and ROME II and to describe predictors of FGIDs among eating disorder (ED) patients. METHODS: Two similar cohorts of female ED inpatients, aged 17-50 years, with no organic gastrointestinal or systemic disorders, completed either the ROME III (n = 100) or the ROME II (n = 160) questionnaire on admission for ED treatment. The two ROME cohorts were compared on continuous demographic variables (e.g., age, BMI) using Student's t-tests, and on categorical variables (e.g., ED diagnosis) using χ(2)-tests. The relationship between ED diagnostic subtypes and FGID categories was explored using χ(2)-tests. Age, BMI, and psychological and behavioural predictors of the common (prevalence greater than 20%) ROME III FGIDs were tested using logistic regression analyses. RESULTS: The criteria for at least one FGID were fulfilled by 83% of the ROME III cohort, and 94% of the ROME II cohort. There were no significant differences in age, BMI, lowest ever BMI, ED diagnostic subtypes or ED-related quality of life (QOL) scores between ROME II and ROME III cohorts. The most prevalent FGIDs using ROME III were postprandial distress syndrome (PDS) (45%) and irritable bowel syndrome (IBS) (41%), followed by unspecified functional bowel disorders (U-FBD) (24%), and functional heartburn (FH) (22%). There was a 29% or 46% increase (depending on presence or absence of cyclic vomiting) in functional gastroduodenal disorders because of the introduction of PDS in ROME III compared to ROME II. There was a 35% decrease in functional bowel disorders (FBD) in Rome III (excluding U-FBD) compared to ROME II. The most significant predictor of PDS was starvation (P = 0.008). The predictor of FH (P = 0.021) and U-FBD (P = 0.007) was somatisation, and of IBS laxative use (P = 0.025). Age and BMI were not significant predictors. The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROME III added precision to many FGIDs. CONCLUSION: ROME III confers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting. Psychological factors appear to be more influential in ROME II than ROME III.
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Wang et al. (2014) conducted a cohort in Eating disorder (n=260). ROME III criteria vs. ROME II criteria was evaluated on Prevalence of at least one functional gastrointestinal disorder (FGID). The prevalence of at least one functional gastrointestinal disorder among female eating disorder inpatients was 83% using ROME III criteria compared to 94% using ROME II criteria.
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