Inconsistent symptom clusters for functional gastrointestinal disorders in Asia: is Rome burning?

Holtmann, Gerald; Talley, Nicholas J.

doi:10.1136/gutjnl-2017-314775

Cited by 31 publications

(27 citation statements)

References 57 publications

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“…In fact, subsequent reports from Australia and from a Rome Foundation study group also found that there are important issues with the Rome IV criteria. 225,226 Future research in Asia should test the Asian symptom clusters against the Rome-proposed symptom clusters. We should also test whether socio-cultural and environmental factors influence the greater overlap between IBS and upper GI symptoms in Asia, and whether this makes it more challenging to recognize IBS here.…”

Section: Discussionmentioning

confidence: 99%

Second Asian Consensus on Irritable Bowel Syndrome

Gwee

Gonlachanvit

Ghoshal

et al. 2019

J Neurogastroenterol Motil

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Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

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Section: Discussionmentioning

confidence: 99%

Second Asian Consensus on Irritable Bowel Syndrome

Gwee

Gonlachanvit

Ghoshal

et al. 2019

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…9 Despite this understanding, studies in Australian populations and in Asian patients with functional symptoms using a locally adapted and validated Rome questionnaire have observed symptom clusters that differ from, and are fewer in number than, the categories proposed in the Rome classification. 16 These findings illustrate the inherent difficulties in the universal application of rigid symptom-based criteria across different countries and cultures. The Rome Foundation recommend that a programme of educational activities is required to disseminate knowledge regarding use of the Rome criteria.…”

Section: [H1] Defining Ibsmentioning

confidence: 95%

Global burden of irritable bowel syndrome: trends, predictions and risk factors

Black

Ford

2020

Nat Rev Gastroenterol Hepatol

318

237

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Irritable bowel syndrome (IBS) is one of the most common disorders of gut-brain interaction worldwide and is defined according to patterns of gastrointestinal symptoms, as described by the Rome diagnostic criteria. However, these criteria, developed with reference to research conducted largely in Western populations, might be limited in their applicability to other countries and cultures. Epidemiological data show a wide variation in the prevalence of IBS globally and more rigorous studies are needed to accurately determine any differences that might exist between countries and potential explanations. The effect of IBS on the individual, in terms of their quality of life, and on healthcare delivery and society, in terms of economic costs, is considerable. Although the magnitude of these effects seems to be comparable between nations, their precise nature can vary based on the existence of societal and cultural differences. The pathophysiology of IBS is complex and incompletely understood; genetics, diet and the gut microbiome are all recognised risk factors, but the part they play might be influenced by geography and culture, and hence their relative importance might vary between countries. This Review aims to provide an overview of the burden of IBS in a global context, to discuss future implications for the care of people with IBS worldwide, and to identify key areas for further research.

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“…Such studies and others are also documenting evidence that the symptom complexes do not necessarily ring true in Asian populations. 41,42…”

Section: G Ener Aliz Ab Ilit Y Of Symp Tom -Ba S Ed Criteriamentioning

confidence: 99%

Irritable Bowel Syndrome: Straightening the road from the Rome criteria

Camilleri

2020

Neurogastroenterology Motil

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The concept of positive diagnosis of irritable bowel syndrome (IBS) based on symptoms kicked off with studies from the University of Bristol; Manning et al identified 4 symptoms that were clearly more common in patients with IBS: abdominal distension as evidenced by tight clothing or visible appearance; pain relief with bowel action; more frequent stools with the onset of pain; and looser stools with the onset of pain. 1 Justification for the development of symptom-based criteria for irritable bowel syndrome is based on the perspectives of several stakeholders: From the patient perspective, effective diagnostic criteria would be expected to improve outcomes by enabling clinicians to diagnose and choose treatments that are likely to be effective. For researchers, accepted criteria would be expected to stratify patient cohorts for research studies. For industry involved in the development of novel approaches to treatment, the availability of effective, evidence-based criteria enables the development of such treatments and convinces regulators and payers that functional gastrointestinal disorders and, specifically, irritable bowel syndrome are real disorders that are amenable to efficacious treatments. A sequence of consensus-based Rome criteria for IBS has been published since 1989 2-5 (Table 1). The fundamental definition based on abdominal pain in association with bowel dysfunction has been consistent. However, 2 major changes occurred in the Rome II and IV criteria. The former change involved "splitting off" of symptoms that were not consistently associated with pain, such as functional, constipation, diarrhea, and bloating. In Rome IV, the main changes have been the exclusion of discomfort (in

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Inconsistent symptom clusters for functional gastrointestinal disorders in Asia: is Rome burning?

Cited by 31 publications

References 57 publications

Second Asian Consensus on Irritable Bowel Syndrome

Second Asian Consensus on Irritable Bowel Syndrome

Global burden of irritable bowel syndrome: trends, predictions and risk factors

Irritable Bowel Syndrome: Straightening the road from the Rome criteria

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