Camilleri Michael
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota.
Clin Gastroenterol Hepatol. 2009 Oct 20;8(2):129. doi: 10.1016/j.cgh.2009.10.009.
Some claim that symptom-based Rome criteria are diagnostic and enhance clinical practice and choice of therapy for patients presenting with gastrointestinal symptoms. This overview focuses on lower gastrointestinal symptoms: constipation, diarrhea, pain and bloating. The main con arguments for using such criteria for diagnosis are: insufficient specificity, overlap of symptom-based categories or disorders, insufficient and therefore non-specific characterization of pain in the criteria, inability to differentiate the "mimics" of IBS-C and IBS-D, and inability to optimize treatment for IBS-M or bloating in the absence of objective measurements. While doctors may not land in trouble using "symptom diagnosis" of IBS, this should not deter them from optimizing diagnosis and treatment of diseases associated with gastrointestinal dysfunction.
一些人声称，基于症状的罗马标准具有诊断性，可改善出现胃肠道症状患者的临床实践和治疗选择。本综述聚焦于下胃肠道症状：便秘、腹泻、疼痛和腹胀。使用此类标准进行诊断的主要反对观点包括：特异性不足、基于症状的类别或病症存在重叠、标准中对疼痛的描述不足因而缺乏特异性、无法区分IBS-C和IBS-D的“模仿者”，以及在缺乏客观测量的情况下无法优化对IBS-M或腹胀的治疗。虽然医生使用IBS的“症状诊断”可能不会陷入麻烦，但这不应妨碍他们优化对与胃肠功能障碍相关疾病的诊断和治疗。
