Rome Foundation-Asian working team report: Asian functional gastrointestinal disorder symptom clusters

Abstract

We found that the broad categorisation used both in clinical practice and in the Rome system, that is, broad anatomical divisions, and certain diagnoses with long historical records, that is, IBS with diarrhoea, and chronic constipation, are still valid in our Asian societies. In addition, we found a bowel symptom cluster with meal trigger and a gas cluster that suggests a different emphasis in our populations. Future studies to compare a non-Asian cohort and to match to putative pathophysiology will help to verify our findings.

Factor Analysis Defines Distinct Upper and Lower Gastrointestinal Symptom Groups Compatible With Rome IV Criteria in a Population-based Study

“…There was also a factor with a combination of upper GI symptoms including functional dyspepsia and overlapping symptoms such as belching and bloating, which was also found by Siah et al 10 Whitehead et al 9 reported…”

“…It remains to be seen whether other languages, countries, or continents (e.g. Asia) would render similar findings, 23 although the recent factor analysis by Siah et al 10 of Rome III shows that any differences are likely to be subtle. A limitation is the absence of information on how many potential respondents chose to ignore the invitation to partake in the survey, despite the close similarity between sample and population demographics.…”

“…Moreover, these factors were quite similar to those reported in factor analyses of earlier Rome editions. [6][7][8][9][10] The IBS factor was the most distinct, with respondents scoring either very high or very low on all defining questions. While constipation and diarrhoea are often seen in IBS patients, IBS is a heterogeneous condition, and as such it is not unexpected to see factors for the core element of IBS (pain related to stool patterns) as well as for the separate stool patterns.…”

“…A similar IBS factor was found by Taub et al 7 and Talley et al 8 Whitehead et al 9 performed a factor analysis on GI symptoms in gastroenterology clinic patients, and reported thirteen distinct factors, including IBS, constipation, diarrhoea, and anorectal pain, but also several upper GI factors. Finally, Siah et al 10 described amongst others a factor of bloating, associated with flatulence and belching. In conclusion, factor analyses can be used to substantiate the definitions of FGIDs.…”

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

“…Recently, Siah et al 9 published results in Gut of an important multicentre study conducted in 11 Asian countries that aimed to validate the Rome III criteria in Asian populations and was sponsored by the Rome Foundation. The authors used a validated and locally adapted version of the Rome III questionnaire (Enhanced Asian Rome 3 Questionnaire),9 tested a large cohort of 1805 patients presenting in primary and secondary care and applied a well-established statistical methodology including principal components factor analysis and varimax rotation.…”