Wang An-jiang, Liao Xian-hua, Hu Pin-jin, Liu Si-chun, Xiong Li-shou, Chen Min-hu
Department of Gastroenterology, the First Affiliated Hospital, SunYat-Sen University, Guangzhou 510080, China.
Zhonghua Nei Ke Za Zhi. 2007 Aug;46(8):644-7.
OBJECTIVE: To determine the degree of agreement of Rome III and Rome II criteria in diagnosing irritable bowel syndrome (IBS) and to compare the clinical difference between the patients diagnosed with these two criteria. METHODS: 3014 patients in the gastrointestinal outpatient department were enrolled consecutively and interviewed face to face with a standard questionnaire. RESULTS: (1) 480 patients were diagnosed as IBS with Rome III criteria. The overall detection rate was 15.9% (480/3014). The proportion of IBS subtypes was as follows: IBS with constipation 27.9% (134/480), IBS with diarrhea 32.7% (157/480), Mixed IBS 6.7% (32/480), Unsubtyped IBS 32.7% (157/480). No difference was observed between different sex and age groups; with Rome II criteria, 558 patients were diagnosed with a detection rate of 18.5% (558/3014). The proportion of IBS subtypes was as follows: constipation predominant IBS 33.2% (185/558), diarrhea predominant IBS 38.2% (213/558), others 28.7% (160/558). The detection rate was higher in female patients (P = 0.002), but there was no difference between different age groups. The detection rate of Rome III criteria was lower than that of Rome II criteria (P = 0.008). There was a good accordance between these two criteria in the diagnosis of IBS (P < 0.01). (2) Patients classified according to Rome III criteria complained more severe abdominal symptoms (P = 0.04) and abnormal bowel habit (P < 0.001) as well as a higher healthcare seeking rate in the last 3 months (35.6% vs 26.5%, P = 0.02) as compared with those classified according to Rome II criteria. (3) According to Rome III criteria, the severity of bowel habit was different among the four subtypes (C-IBS, M-IBS > D-IBS > U-IBS, P < 0.005) while no difference was observed on the abdominal symptoms and the healthcare seeking rates in the last 3 months. CONCLUSIONS: There is a good accordance between Rome II and Rome III criteria in diagnosing IBS. Compared to Rome II criteria, Rome III criteria has a lower detection rate. It is more practical in the clinical practice with clear definition of symptom frequency and easy way of subtyping IBS. The patients diagnosed with Rome III criteria had more severe symptoms and higher healthcare seeking rate, they are more suitable for clinical trial.
目的：确定罗马Ⅲ标准与罗马Ⅱ标准在诊断肠易激综合征（IBS）中的一致性程度，并比较依据这两种标准诊断的患者之间的临床差异。 方法：连续纳入3014例胃肠门诊患者，并采用标准问卷进行面对面访谈。 结果：（1）采用罗马Ⅲ标准诊断为IBS的患者有480例。总体检出率为15.9%（480/3014）。IBS各亚型比例如下：便秘型IBS 27.9%（134/480），腹泻型IBS 32.7%（157/480），混合型IBS 6.7%（32/480），未分型IBS 32.7%（157/480）。不同性别和年龄组之间未观察到差异；采用罗马Ⅱ标准时，558例患者被诊断为IBS，检出率为18.5%（558/3014）。IBS各亚型比例如下：便秘为主型IBS 33.2%（185/558），腹泻为主型IBS 38.2%（213/558），其他28.7%（160/558）。女性患者的检出率较高（P = 0.002），但不同年龄组之间无差异。罗马Ⅲ标准的检出率低于罗马Ⅱ标准（P = 0.008）。这两种标准在IBS诊断方面具有良好的一致性（P < 0.01）。（2）与依据罗马Ⅱ标准分类的患者相比，依据罗马Ⅲ标准分类的患者抱怨有更严重的腹部症状（P = 0.04）、排便习惯异常（P < 0.001）以及在过去3个月中更高的就诊率（35.6%对26.
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