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Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.
World J Gastroenterol. 2014 Nov 21; 20(43):16293-9.WJ

Abstract

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.

Authors+Show Affiliations

Xiaojie Wang, Catherine Boyd, Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, Australia.Xiaojie Wang, Catherine Boyd, Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, Australia.Xiaojie Wang, Catherine Boyd, Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, Australia.Xiaojie Wang, Catherine Boyd, Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, Australia.Xiaojie Wang, Catherine Boyd, Department of Obstetrics and Gynaecology, University of Sydney, NSW 2006, Australia.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

25473186

Citation

Wang, Xiaojie, et al. "Functional Gastrointestinal Disorders in Eating Disorder Patients: Altered Distribution and Predictors Using ROME III Compared to ROME II Criteria." World Journal of Gastroenterology, vol. 20, no. 43, 2014, pp. 16293-9.
Wang X, Luscombe GM, Boyd C, et al. Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria. World J Gastroenterol. 2014;20(43):16293-9.
Wang, X., Luscombe, G. M., Boyd, C., Kellow, J., & Abraham, S. (2014). Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria. World Journal of Gastroenterology, 20(43), 16293-9. https://doi.org/10.3748/wjg.v20.i43.16293
Wang X, et al. Functional Gastrointestinal Disorders in Eating Disorder Patients: Altered Distribution and Predictors Using ROME III Compared to ROME II Criteria. World J Gastroenterol. 2014 Nov 21;20(43):16293-9. PubMed PMID: 25473186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria. AU - Wang,Xiaojie, AU - Luscombe,Georgina M, AU - Boyd,Catherine, AU - Kellow,John, AU - Abraham,Suzanne, PY - 2014/04/04/received PY - 2014/05/20/revised PY - 2014/06/21/accepted PY - 2014/12/5/entrez PY - 2014/12/5/pubmed PY - 2015/9/4/medline KW - Anorexia nervosa KW - Bulimia nervosa KW - Eating disorders KW - Gastrointestinal diseases KW - Irritable bowel syndrome SP - 16293 EP - 9 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 20 IS - 43 N2 - 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. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25473186/Functional_gastrointestinal_disorders_in_eating_disorder_patients:_altered_distribution_and_predictors_using_ROME_III_compared_to_ROME_II_criteria_ L2 - http://www.wjgnet.com/1007-9327/full/v20/i43/16293.htm DB - PRIME DP - Unbound Medicine ER -