Symptom-based ordinal scale fuzzy clustering of functional gastrointestinal disorders

Background The validity of Rome III criteria for diagnosing functional gastrointestinal disorders (FGIDs) have been frequently questioned in the literature. In epidemiology, when a disease is diagnosed, the existence of a true cluster must be proven. Thus, clustering the common GI symptoms of individuals and comparing the clusters with FGIDs defined by the Rome III criteria could provide insights about the validity of FGIDs defined by those criteria. Well-separated compact clusters were detected in responses to questionnaires of the epidemiological features of different FGIDs in Iranian adults using fuzzy ordinal clustering. The representative sample from each cluster i.e. Cluster Representative (CR) was formed whose corresponding FGID was diagnosed with Rome III criteria. Then, FGID diagnosis was performed for all participants in each cluster and the percentage of cases whose FGID was the same as the cluster's identified FGID (agreement) was reported. Results Fourteen valid clusters were detected in 4763 people. The average membership of the objects in each cluster was 77.3%, indicating similarity of the objects in clusters to their corresponding CRs. Eight clusters were assigned to single FGIDs (irritable bowel syndromes: constipation IBS-C, diarrhea IBS-D and un-subtyped IBS-U; functional bloating FB; functional constipation FC; belching disorder BD. The agreement was higher than 50% in single FGID clusters except those whose diagnosis was IBS-U. Conclusions IBS-C, IBS-D, FC, BD, and FB defined with Rome III criteria exist in the population, which is not the case for IBS-U.

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Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses

European Journal of Pediatrics ◽

10.1007/s00431-021-04013-2 ◽

2021 ◽

Author(s):

Desiree F. Baaleman ◽

Carlos A. Velasco-Benítez ◽

Laura M. Méndez-Guzmán ◽

Marc A. Benninga ◽

Miguel Saps

Keyword(s):

Diagnostic Criteria ◽

Functional Dyspepsia ◽

Functional Gastrointestinal Disorders ◽

Functional Constipation ◽

Final Analysis ◽

Gastrointestinal Disorders ◽

Rome Iii ◽

Sample Characteristics ◽

Irritable Bowel ◽

Rome Iv

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.

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Prevalence of Functional Gastrointestinal Disorders according to Rome III Criteria in Italian Morbidly Obese Patients

The Scientific World JOURNAL ◽

10.1155/2013/532503 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Antonella Santonicola ◽

Luigi Angrisani ◽

Carolina Ciacci ◽

Paola Iovino

Keyword(s):

Distress Syndrome ◽

Behavior Pattern ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Disorders ◽

Morbidly Obese ◽

Obese Patients ◽

Rome Iii Criteria ◽

Gi Symptoms ◽

Rome Iii ◽

Frequency Intensity

The relationship between GI symptoms and obesity has yet to be completely clarified.Aim. To determine in a morbidly obese southern Italy adult population the prevalence of Functional Gastrointestinal Disorders (FGID) and its association with the presence of a Binge Eating (BE) behavior pattern.Methods. Consecutive obese patients eligible for bariatric surgery and 100 Healthy Controls (HC) were recruited. All participants were questioned and scored for the presence of FGID according to Rome III criteria and for the presence or the frequency-intensity of a number of upper and lower GI symptoms. BE behavior pattern was assessed.Results. One-hundred obese patients met the inclusion criteria. The prevalence of FGID was similar between obese patients and HC. There was a significant association between obese patients with BE behavior and postprandial distress syndrome (P=0.04). Moreover, a significantly higher frequency-intensity score for epigastric fullness (1.23±0.45versus0.35±0.13,P=0.01) was found in obese patients with BE behavior compared to obese patients without.Conclusions. Obese patients with a BE behavior pattern showed a significantly higher prevalence of postprandial distress syndrome. A greater knowledge of the GI symptoms associated with obesity along with the pathophysiological mechanisms underlying will be important in the clinical management of these patients.

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Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

10.21203/rs.3.rs-594914/v1 ◽

2021 ◽

Author(s):

Hwanseok Jung ◽

Eun-Jung Rhee ◽

Mi Yeon Lee ◽

Jung Ho Park ◽

Dong Il Park ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Diabetes Complications ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Gi Symptoms ◽

Irritable Bowel ◽

Diabetes Patients

Abstract Background: Gastrointestinal (GI) manifestations are common in patients with diabetes complications such as autonomic neuropathy. However, the prevalence of GI symptoms before the development of diabetes complications remains unclear.Method: We performed an interview survey of functional gastrointestinal disorders in diabetes patients who visited the endocrinology clinic of a general hospital using the ROME III criteria. The investigation consisted of various questions on functional dyspepsia, irritable bowel syndrome, and functional constipation including functional defecation disorder.Results: A total of 509 patients were included in this analysis. The patients were analyzed in three groups, prediabetes patients (n = 115), diabetes patients without neuropathy (n = 275), and diabetes patients with neuropathy (n = 119). The prevalence of gastrointestinal symptoms in prediabetes patients, diabetes patients without neuropathy, and diabetes patients with neuropathy was estimated at 16.52%, 27.27%, and 23.53% for functional dyspepsia; 8.7%, 11.68%, and 16.81% for irritable bowel syndrome; and 8.85%, 11.85%, and 15.25% for functional constipation. In the subgroup analysis, postprandial distress syndrome symptoms such as postprandial fullness and early satiation were more prevalent than epigastric pain symptoms. In the constipation group, pelvic outlet obstruction symptoms such as the sensation of anorectal obstruction or blockage and manual maneuvers to facilitate defecation were more frequently observed than slow transit constipation symptomsConclusions: The prevalence of functional gastrointestinal disorders increased with diabetes severity. Diabetes-related GI symptoms appeared long before the diabetes complications

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A69 MULTIPLE FUNCTIONAL GASTROINTESTINAL DISORDERS IN JORDANIAN CHILDREN, NATIONWIDE STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.068 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 82-83

Author(s):

E Altamimi

Keyword(s):

Functional Gastrointestinal Disorders ◽

Functional Constipation ◽

Arabic Language ◽

Cross Sectional Study ◽

Gastrointestinal Disorders ◽

Rome Iii Criteria ◽

Cross Sectional ◽

Funding Agencies ◽

Rome Iii ◽

Common Combination

Abstract Background Functional gastrointestinal disorders (FGIDs) are common in children worldwide. Multiple FGIDs might share some etiopathogenesis, which makes finding multiple disorders in a child a possibility. Aims Estimate the prevalence of FGIDs in Jordanian children prospectively, whether as a single or combined disorders. Methods A prospective, cross-sectional study was conducted in 6 cities in Jordan. Children between the ages of 4–18 were recruited. A validated Arabic language questionnaires based on Rome III criteria were filled by the participants if older than 10 years and by the parents if younger than 10 years. Results A total of 1587(79.35%) participants filled the questionnaires. 814 (51.29%) were younger than 10 years. FGIDs was diagnosed in 204 (25.03%) of younger children. In children between (11 and 18), 310 (40%) were diagnosed with FGIDs. In children (4–10 yrs.) who were diagnosed with FGIDs, 15.5 % had two disorders, while 3% had three or more disorders. The most common combination was aerophobia and functional constipation, comprising 22.58% of combined disorders. In children (11–18 yrs.) with FGIDs, 22.27% had two disorders and 7% had three or more disorders. Interestingly, the most common combination was aerophagia and functional constipation also, representing 34% of the combined cases. Conclusions Functional gastrointestinal disorders are common in Jordanian children. Multiple Functional gastrointestinal disorders may coexist. Diagnosis of one disorder should not prevent us from investigating other disorders. Funding Agencies None

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Patterns of alternation in irritable bowel syndrome

Medicine and Pharmacy Reports ◽

10.15386/cjmed-589 ◽

2016 ◽

Vol 89 (2) ◽

pp. 220-223 ◽

Cited By ~ 1

Author(s):

Alexandra Chira ◽

Mihaela Filip ◽

Dan Lucian Dumitraşcu

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Gastrointestinal Disorders ◽

Structured Interview ◽

Pharmacological Therapy ◽

Gastrointestinal Disorders ◽

Rome Iii Criteria ◽

Rome Iii ◽

Stool Form ◽

Irritable Bowel ◽

Over Time

Background and aims. Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, having its subtypes related to the predominant bowel pattern: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M) or alternating IBS (IBS-A). Some patients alternate between subtypes (IBS-A). We looked for the prevalence of alternation between subtypes in patients with IBS. We also analyzed changes in pharmacological therapy specifically addressed to IBS.Methods. We performed a retrospective observational study that included 60 patients diagnosed with IBS according to Rome III criteria. Patients were asked using a detailed structured interview about their stool form changes regarding previous six months. Alternators were defined as patients that changed IBS subtype over time (previous six months).Results. Out of the 60 patients diagnosed with IBS, 18 patients (30%) were alternators. Of these, 8 patients (44%) changed twice the subtype. Two patients (66.66%) of the IBS-M subgroup shifted between subtypes. Eight patients (44.44%) changed medication over the six months. Four patients (22.2%) of the alternators were on double association of therapy (antispasmodics) addressed to IBS. Four patients (22.22%) discontinued medication.Conclusions. Patients with IBS often change between subtypes even within six months. Alternators in our pilot study represented 30% of IBS patients. IBS-M seems to be the least stable phenotype. The rarest change is the shift between IBS-C and IBS-D. Alternators also often change their pharmacological treatment (antispasmodics).

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Approach to a Child with Irritable Bowel Syndrome: A Review

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v2i1.32969 ◽

2017 ◽

Vol 2 (1) ◽

pp. 34-39

Author(s):

Md Rukunuzzaman ◽

ASM Bazlul Karim ◽

Wahiduzzaman Mazumder ◽

Mohammed Nurullah ◽

Faika Hussain ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Gastrointestinal Disorders ◽

Physiological Mechanism ◽

Bowel Habit ◽

Gastrointestinal Disorders ◽

Rome Iii Criteria ◽

Functional Bowel Disorder ◽

Rome Iii ◽

Irritable Bowel ◽

Bowel Disorder

Irritable bowel syndrome (IBS) is one of the most common and best studied disorders among the group of functional gastrointestinal disorders. It is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. Visceral hypersensitivity and increased GIT motility are the main patho-physiological mechanism for developing IBS. IBS present with diarrhoea or constipation or both. Investigations are least needed for diagnosis of IBS rather done to exclude differential diagnosis. Diagnosis of IBS is done on the basis of Rome-III criteria. Proper counseling, dietary management, antispasmotic and antidepressant are the mainstay of treatment. Journal of National Institute of Neurosciences Bangladesh, 2016;2(1): 34-39

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Gastrointestinal Symptoms of Patients with Fabry Disease

Gastroenterology Research and Practice ◽

10.1155/2016/9712831 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Licia Pensabene ◽

Simona Sestito ◽

Angela Nicoletti ◽

Francesca Graziano ◽

Pietro Strisciuglio ◽

...

Keyword(s):

Abdominal Pain ◽

Fabry Disease ◽

Functional Gastrointestinal Disorders ◽

Rome Iii Criteria ◽

Functional Bowel Disorder ◽

Abdominal Bloating ◽

Gi Symptoms ◽

Rome Iii ◽

Functional Bloating ◽

Bowel Disorder

In order to characterize gastrointestinal (GI) symptoms of 50 patients with Fabry disease (FD) (22 M; age range: 4–70 y; 35 adults and 15 children), validated questionnaires of GI symptoms were used to diagnose the functional gastrointestinal disorders (FGIDs) of the patients with GI symptoms (33/50 (66%); 25/35 adults and 8/15 children) according to Rome III criteria. In 16/25 of these adults and 2/8 of these children, the symptoms mimicked FGID. The adult subgroup included patients with unspecified functional bowel disorder (n=9), functional bloating (n=7), and IBS (n=5), and the child subgroup included patients with abdominal migraine (n=1) and IBS (n=1). Among the 25 adults, 14 reported feeling full after a regular-size meal, and 12 complained of abdominal bloating/distension. All of the children with GI symptoms complained of low abdominal pain associated with changes in the form of the stool/improvements with defecation. In conclusion, according to Rome III criteria, the most frequent diagnoses of FGID among the adults with FD were unspecified functional bowel disorder, followed by functional bloating and IBS. The most frequent GI symptom in the children in our population was IBS-like abdominal pain, while the adults exhibited a full feeling following a regular-size meal and abdominal bloating/distension.

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Symptomatic Treatment of Pain-Related Pediatric Functional Gastrointestinal Disorders in a Biopsychosocial Construct, and a Validity Study of Rome III Criteria

Clinical Pediatrics ◽

10.1177/00099228211007964 ◽

2021 ◽

Vol 60 (6-7) ◽

pp. 304-313

Author(s):

Shailender Madani ◽

Rohit Madani ◽

Suchi Parikh ◽

Ahila Manivannan ◽

Wilma R. Orellana ◽

...

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Functional Gastrointestinal Disorders ◽

High Specificity ◽

Symptomatic Treatment ◽

Gastrointestinal Disorders ◽

Organic Disease ◽

Rome Iii Criteria ◽

Rome Criteria ◽

Rome Iii

Our study aims to assess improvement with symptomatic treatment of pain-related functional gastrointestinal disorders (FGIDs) in a biopsychosocial construct and evaluate validity of Rome III criteria. Children with chronic abdominal pain diagnosed with an FGID or organic disease were followed for 1 year: 256/334 were diagnosed with an FGID and 78/334 were diagnosed with a possible organic disease due to alarm signs or not meeting Rome III criteria. After 1 year, 251 had true FGID and 46 had organic diseases. Ninety percent of FGID patients improved with symptomatic treatment over an average of 5.4 months. With a 95% confidence interval, Rome criteria predicted FGIDs with sensitivity 0.89, specificity 0.90, positive predictive value 0.98, and negative predictive value 0.59. We conclude that symptomatic treatment of pain-related FGIDs results in clinical improvement and could reduce invasive/expensive testing. Rome III criteria’s high specificity and positive predictive value suggest they can rule in a diagnosis of FGID.

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Impact of Opioid Consumption in Patients With Functional Gastrointestinal Disorders

Frontiers in Pharmacology ◽

10.3389/fphar.2020.596467 ◽

2020 ◽

Vol 11 ◽

Author(s):

Chloé Melchior ◽

Charlotte Desprez ◽

Fabien Wuestenberghs ◽

Anne-Marie Leroi ◽

Antoine Lemaire ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Functional Gastrointestinal Disorders ◽

Opioid Consumption ◽

University Hospital ◽

Gastrointestinal Disorders ◽

Gi Symptoms ◽

Irritable Bowel

Objective: We aimed to determine the burden of opioid consumption in a cohort of patients with functional gastrointestinal disorders.Methods: All patients diagnosed with functional gastrointestinal disorders and referred to our university hospital were evaluated from 2013 to the beginning of 2019. Irritable bowel syndrome and functional dyspepsia diagnoses were determined according to Rome criteria and severity according to irritable bowel syndrome severity scoring system. Vomiting was quantified using a 5-point Likert scale, and constipation severity was measured using the Knowles-Eccersley-Scott-Symptom questionnaires. Quality of life was quantified by the GastroIntestinal Quality of Life Index. Patients were categorized as being treated on a chronic basis with either tramadol, step II opioids, step III opioids or as being opioid-free.Results: 2933 consecutive patients were included. In our cohort, 12.5% had only irritable bowel syndrome, 39.3% had only functional dyspepsia, 24.9% had a combination of both, and 23.4% had other functional gastrointestinal disorders. Among them, the consumption of tramadol, step II (tramadol excluded) and step III opioids was 1.8, 1.3 and 0.3 % respectively in 2013 and 4.3, 3.4 and 1.9% in 2018 (p < 0.03). Opioid consumption was associated with increased vomiting (p = 0.0168), constipation (p < 0.0001), symptom severity (p < 0.001), more altered quality of life (p < 0.0001) and higher depression score (p = 0.0045).Conclusion: In functional gastrointestinal disorders, opioid consumption has increased in the last years and is associated with more GI symptoms (vomiting, constipation and GI severity), higher depression and more altered quality of life.

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