Functional chronic constipation: Rome III criteria versus Rome IV criteria

Russo, María Luisa; Strisciuglio, Caterina; Casertano, Marianna; Russo, G; Caprio, Angela Maria; Campanile, Riccardo Garruto; Miele, Erasmo; Staiano, Annamaria

doi:10.1016/j.dld.2017.09.087

Cited by 13 publications

(17 citation statements)

References 5 publications

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“…Our findings contrast with studies from other countries that also used the Rome IV criteria and reported a lower prevalence of FC (12% United States; 13.6% Italy). 10,11 This suggests that changes in the Rome IV criteria (compared to the Rome III criteria) in this age group did not modify the overall prevalence of FC and that the prevalence of FC seems to vary among regions.…”

Section: Discussionmentioning

confidence: 78%

The impact of incorporating toilet‐training status in the pediatric Rome IV criteria for functional constipation in infant and toddlers

Saps

Velasco-Benítez

Valdés

et al. 2020

Neurogastroenterology Motil

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Background The diagnosis of functional constipation (FC) is based on the Rome criteria. The last edition of the criteria (Rome IV) for infants and toddlers modified the criteria to differentiate toilet‐trained (TT) and non‐toilet‐trained (NTT) children. These changes have not been validated. We aimed to understand the impact of adding toilet training to the diagnostic criteria and to assess the prevalence of FC. Methods Parents of infants and toddlers from six outpatient clinics (four public, two private) located in three geographically dispersed cities in Colombia completed validated questionnaires to diagnose functional gastrointestinal disorders according to Spanish version of Rome IV criteria (QPGS‐IV). Results A total of 1334 children (24.4 months ±15.0) participated: 482 (36%) TT and 852 (64%) NTT. The prevalence of FC was 21.1%. The prevalence increased with age, 0‐1 years 7.7%; 2 years 18.2%; 3 years 23.7%; and 4 years 37.2%. TT vs NTT for FC 41.9% vs 9.3%, respectively (OR 7.06, 95% CI 5.26‐9.47, P < .0001). TT more likely to report ≥ 3 criteria (OR = 2.43, 95% CI 1.41‐4.21, P = .0015). 18.3% of TT had episodes of fecal incontinence that met the frequency required by Rome for FC (≤1 episode/week). However, 87.1% had fecal incontinence less often. 7.4% of them characterized as large quantity. Conclusion We found no changes in the prevalence of FC using the Rome IV criteria vs Rome III. TT children are more likely to have FC. Study suggests that changes in Rome IV criteria were potentially clinically relevant and to have adequate face validity. Future studies should confirm our findings.

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Section: Discussionmentioning

confidence: 78%

The impact of incorporating toilet‐training status in the pediatric Rome IV criteria for functional constipation in infant and toddlers

Saps

Velasco-Benítez

Valdés

et al. 2020

Neurogastroenterology Motil

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“…The QPGS-IV has been used to estimate the prevalence of FGIDs in multiple studies in children. 1,5 Studies comparing the prevalence of FGIDs in children using the Rome III and Rome IV criteria have shown differences in prevalence predominantly in abdominal migraine, irritable bowel syndrome (IBS), and functional dyspepsia. 1,2 It is important to understand if those differences resulted from modifications of the Rome criteria or innate errors in measures.…”

Section: Introductionmentioning

confidence: 99%

Can We Rely on the Rome IV Questionnaire to Diagnose Children With Functional Gastrointestinal Disorders?

Baaleman

Velasco-Benítez

Méndez-Guzmán

et al. 2021

J Neurogastroenterol Motil

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Background/AimsTo investigate the intra-rater (test-retest) reliability of the diagnosis of functional gastrointestinal disorders (FGIDs) as measured by the Questionnaire on Pediatric Functional Gastrointestinal Disorders, Rome IV version (QPGS-IV) in children. MethodsA prospective cohort study was conducted in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the self-report Spanish version of the QPGS-IV at day 0 (baseline) and at day 2 (48 hours later). ResultsThe study protocol was completed by 215 children, of which 97 (45%) were excluded from analysis due to the inability to follow the questionnaire's instructions. The final analysis included data of 118 children (mean age 15.0 ± SD 1.8 years old, 58.5% boys). The most common diagnoses were functional dyspepsia, functional constipation, and irritable bowel syndrome. We found a moderate intra-rater reliability (κ = 0.61-0.65) for diagnosing an FGID in general, a functional abdominal pain disorder, and the diagnosis of functional dyspepsia. We found a weak intra-rater reliability (κ = 0.46-0.54) for diagnosing a functional defecation disorder, functional constipation, irritable bowel syndrome, and the postprandial distress syndrome subtype of functional dyspepsia. ConclusionsOur study shows that a large proportion of children cannot adequately complete the QPGS-IV and that the intra-rater reliability among those who did adequately follow the instructions is moderate. We advise to test the children's understanding of the instructions prior to completion of questionnaires and recommend to not rely exclusively on a self-reported questionnaire to select, recruit, or evaluate pediatric patients for FGIDs for research purposes.

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“…Similar to these American reports (21) and previous Mediterranean work, in our present population, the most frequent FGID in both age groups was FC, with a prevalence ranging between 7.46% in children to 13.7% in adolescents. In the youngest group, FC was significantly less identified with Rome IV criteria in the Mediterranean area although in the previous report its prevalence (11.7%) was higher compared with other studies (2,19,22). In a recent systematic review and meta-analysis of studies using comparable methodology and all iterations of the Rome criteria, the pooled prevalence of FC was 15.3% (95% CI 8.1–24.4; I 2 = 99.4%) in studies using the Rome I criteria, 11.2% (7.9–14.9; I 2 = 99.6%) in studies that used Rome II criteria, 10.4% (6.5–14.9; I 2 = 99.8%) in those that used Rome III criteria, and 10.1% (8.7–11.6; I 2 = 98.2%) when Rome IV criteria were used.…”

Section: Discussionmentioning

confidence: 78%

Functional Gastrointestinal Disorders in Mediterranean Countries According to Rome IV Criteria

Strisciuglio

Cenni

Serra

et al. 2021

J. pediatr. gastroenterol. nutr.

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Objectives: The aim of this study was to assess the prevalence of functional gastrointestinal disorders (FGIDs) in children of Mediterranean area using Rome IV criteria and to compare the prevalence of FGIDs using Rome IV and Rome III criteria. Methods: This was a cross-sectional study enrolling children and adolescents living in Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects were examined in relation to the presence of FGIDs, using the Rome IV criteria. Data were compared with the results of a previous study using Rome III data. Results: We analyzed 1972 children ages 4 to 9 years (group A), and 2450 adolescents 10 to 18 years old (group B). The overall prevalence of FGIDs was 16% in group A and 26% in group B, with statistical differences among countries in both groups (P < 0.001). In group A, the prevalence of FGIDs and of functional constipation (FC) was significantly lower than in the previous study (P < 0.001), whereas in group B no significant difference was found. In both groups of age, the prevalence of abdominal migraine and irritable bowel syndrome decreased significantly (P < 0.001 and P < 0.001, respectively) using Rome IV versus Rome III criteria, conversely functional dyspepsia increased (P < 0.001). Conclusions: FGIDs are common in children and adolescents, their frequency increases with age, and there is a significant variation in the prevalence of some FGIDs among different European countries. The application of the Rome IV criteria resulted in a significantly lower prevalence of FGIDs in children compared with Rome III criteria.

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Functional chronic constipation: Rome III criteria versus Rome IV criteria

Cited by 13 publications

References 5 publications

The impact of incorporating toilet‐training status in the pediatric Rome IV criteria for functional constipation in infant and toddlers

The impact of incorporating toilet‐training status in the pediatric Rome IV criteria for functional constipation in infant and toddlers

Can We Rely on the Rome IV Questionnaire to Diagnose Children With Functional Gastrointestinal Disorders?

Functional Gastrointestinal Disorders in Mediterranean Countries According to Rome IV Criteria

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