Functional Gastrointestinal Disorders Diagnosed by Rome III Questionnaire in Korea

Abstract

Background/AimsRome criteria classifying functional gastrointestinal disorder (FGID) were updated. The aims of this study were to assess the spectra of FGID and to evaluate the applicability of Rome III criteria in Korea.MethodsNew patients who visited 2 primary clinics and 2 tertiary care hospitals were consecutively invited to complete questionnaires. These consisted of questionnaires for FGID based on Rome III criteria and symptom checklist-90-revised for somatization, depression and anxiety.ResultsA total of 786 patients was participated. Among them, FGID was observed in 49.7%. In the patients with FGID, functional dyspepsia was most common (46.0%) followed by irritable bowel syndrome (IBS, 40.2%). Functional dyspepsia was most common both in the primary care clinics and tertiary care hospitals. Postprandial distress syndrome was the most common subtype and the frequency of epigastric pain syndrome was low. There were few responders for constipation as Bristol types 1 and 2 and for diarrhea as types 6 and 7 in subtype classification using the Bristol Stool Form Scale. Thereby, unspecified IBS defined by stool form was unexpectedly common in 43.9% of IBS, whereas unspedified IBS defined by Rome III definition was 5.1%. Patients with overlap FGIDs had higher score of anxiety, depression or somatization.ConclusionsFGIDs were common both in primary care clinics and tertiary care hospitals of Korea. Overlap FGIDs is still common by Rome III criteria, which may limits its wide application.

Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report

“…However, in a study from South Korea, close to three-quarters of patients with IBS who had verbally reported passing hard stools, failed to meet this criteria. 31 We found some evidence that point to a relatively shorter colonic transit time among Asians compared with those reported in the West, both for healthy volunteers as well as subjects with constipation. 3,25 To allow the patient's perspectives to be taken into consideration, we introduced a new approach of asking patients what type of stools were passed when they felt they were experiencing constipation, diarrhoea or normal bowel habits.…”

Pros and Cons While Looking Through an Asian Window on the Rome IV Criteria for Irritable Bowel Syndrome: Pros

“…11,12 However, a Korean study suggested that including type 3 stool increased the sensitivity to diagnose constipation. 32 The Asian consensus on IBS suggested that in addition to Bristol types 1 and 2 stool, type 3 stool should also be considered as constipation in Asia…”

Assessment of the Asian Neurogastroenterology and Motility Association Chronic Constipation Criteria: An Asian Multicenter Cross-sectional Study

“…For instance, patients from Asia have a shorter colonic transit time than Western patients, and in South Korea most patients who experience hard stools do not meet Rome criteria for hard stools. 5,9 There are also differences within Asia; in India, patients with self-perceived constipation report a median of 2 bowel movements per day 10 and in China, where there are marked regional differences in the prevalence of constipation. 11 Similarly, and as observed in our results, there are slight differences in the prevalence of CC among Malays, Indians, and Chinese in Singapore.…”

“…4 More recently, in a study of 26 patients with irritable bowel syndrome (IBS) from South Korea who considered that they were passing hard stools, only 7 met the definition of hard stool by the Rome III criteria (Bristol stool form scale type 1 or type 2). 5 These findings highlighted the need for a simple and practical tool adapted for the diagnosis of CC in the Asian population. As a result, the ANMA proposed a practical approach to the diagnosis of CC, which they called the ANMA CC tool.…”