Nationwide Survey for Application of ROME IV Criteria and Clinical Practice for Functional Constipation in Children

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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Increased psychological distress and somatization in patients with irritable bowel syndrome compared with functional diarrhea or functional constipation, based on Rome IV criteria

Neurogastroenterology & Motility ◽

10.1111/nmo.14121 ◽

2021 ◽

Author(s):

Mohamed G. Shiha ◽

Zohaib Asghar ◽

Mo Thoufeeq ◽

Matthew Kurien ◽

Alex J. Ball ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Psychological Distress ◽

Functional Constipation ◽

Functional Diarrhea ◽

Irritable Bowel ◽

Rome Iv

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Prevalence of functional gastrointestinal disorders in infants and young children in China

BMC Pediatrics ◽

10.1186/s12887-021-02610-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ying Huang ◽

Serene Yaling Tan ◽

Panam Parikh ◽

Vanitha Buthmanaban ◽

Shaman Rajindrajith ◽

...

Keyword(s):

Young Children ◽

Maternal Education ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Cross Sectional ◽

Validated Questionnaire ◽

Rome Iv ◽

Infants And Young Children

Abstract Background The prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China. Methods A prospective, cross-sectional, community-based survey was conducted among healthy infants and young children between the ages of 0–4 years in Jinhua and Shanghai, China. A total of 2604 subjects (1300 subjects from Jinhua and 1304 subjects from Shanghai) completed a validated questionnaire on pediatric gastrointestinal symptoms. FGIDs in infants and young children were diagnosed using the Rome IV criteria. Results According to the Rome IV criteria, the prevalence of having a FGID in Chinese infants and young children is 27.3%. Infant regurgitation (33.9%) was the most common FGID among the 0–6 months old while functional constipation (7.0%) was the most common among the 1–4 years old. Risk factor analysis revealed that prevalence of infantile colic was higher with better maternal education and low birth weight. Prevalence of infantile regurgitation was significantly greater in males, living in a rural area, being exclusively breast fed at least up to 4 months and starting formula feeds within the first month. The risk of functional constipation was lower for infants who were delivered vaginally. Conclusions Infantile regurgitation was the most common FGID in Chinese infants while functional constipation was most prevalent among young Chinese children. Trial registration Netherlands Trial Registry Identifier: NL6973/NTR7161.

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Prevalence and risk factors of functional constipation in the Rome IV criteria during a medical check‐up in Japan

Journal of Gastroenterology and Hepatology ◽

10.1111/jgh.15436 ◽

2021 ◽

Author(s):

Koji Otani ◽

Toshio Watanabe ◽

Kanae Takahashi ◽

Yuji Nadatani ◽

Shusei Fukunaga ◽

...

Keyword(s):

Risk Factors ◽

Functional Constipation ◽

Rome Iv

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MO515CONSTIPATION IN CHRONIC KIDNEY DISEASE: PREVALENCE AND RISK FACTORS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab087.0035 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Sourabh Sharma ◽

Neha Sharma ◽

Kailash Sharma

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Tertiary Care ◽

Functional Constipation ◽

Common Symptom ◽

Psychological Burden ◽

Ckd Stage ◽

Stool Form ◽

Rome Iv

Abstract Background and Aims Among various gastrointestinal disorders, constipation is one of the most common symptom in chronic kidney disease (CKD). However it is often neglected by nephrologists as self-limiting condition. Constipation impacts quality of life in multiple ways and increases socio-psychological burden. Constipation and associated risk factors have been poorly studied and most studies are retrospective. Method We enrolled CKD stage 3 to 5 patients on regular follow-up with nephrologist from June 2018 to June 2020, at a tertiary care centre in North India. Constipation was defined using Rome IV criteria (Functional constipation) which is composed of six constipation related symptoms, and diagnosis of constipation is established by presence of two or more symptoms for at least 3 months. Patients were also asked to maintain a 7 day prospective stool diary. It consisted of seven day written prospective chart of stool form and frequency. Patients were instructed to record when each bowel movement happened and to mark stool form type for each movement as described in words and pictures on Bristol Stool Form Scale (BSFS). Opioid induced constipation was defined as per Rome IV criteria. The diagnostic criteria is similar to functional constipation, but with requisite that new or worsening symptoms occurred when initiating, changing or increasing opioid therapy. Results Two hundred twenty five patients were studied out of which 59 (26.2%) patients were in CKD stage3, eighty one (36%) patients were in CKD stage4 and 85 (37.8%) patients were in stage5. Out of 85 CKD stage5 patients, 23 (27%) were on dialysis. Mean age of patients was 49.1 years. Out of 225 patients, 135 (60%) were male. Constipation symptoms and diagnosis reported in each stage has been depicted in Table 1. Clinical correlates of constipation has been depicted in Table 2. Conclusion Constipation measured using Rome IV criteria affects around two-third of CKD stage 3-5 patients. Diabetes, hypertension and opioid use has been found to be significantly associated with constipation.

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Attitudes and beliefs of emergency physicians on lab tests utilization in clinical practice. A multicenter survey

Emergency Care Journal ◽

10.4081/ecj.2019.8237 ◽

2019 ◽

Vol 15 (3) ◽

Author(s):

Carlotta Saccenti ◽

Marco Lunian ◽

Martina Montagnana ◽

Andrea Balloni ◽

Giulia Maria Azin ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Pathways ◽

Medical Knowledge ◽

Nationwide Survey ◽

Laboratory Diagnostics ◽

Attitudes And Beliefs ◽

Emergency Physicians ◽

Digital Format ◽

Multicenter Survey ◽

Real Scenario

It is commonly perceived that the main obstacle for an effective partnership between Emergency Medicine (EM) and Laboratory Medicine (LM) is the lack of reciprocal knowledge and understanding. A further aspect is a partial comprehension of clinical significance and implications of some tests. The real scenario of attitudes and beliefs of Emergency Physicians (EPs) on lab tests utilization in clinical practice remains largely unclear. Therefore, this original study was designed to explore this field of medical knowledge, by using a survey on attitudes and beliefs in laboratory diagnostics which was disseminated among many Italian EPs. A questionnaire containing 20 different items/statements was designed and then disseminated either directly, or in a digital format. Overall, 183 questionnaires were compiled and collected. The results of this nationwide survey seem to confirm the existence of a suboptimal knowledge of both clinical and economic impact of urgent laboratory tests by Italian EPs. An unsatisfactory relationship between EPs and laboratory professionals seems also to emerge. Several EPs attribute this to Shortage of time to think (18.6%), followed by Fair of medical-legal litigation (13.6%). On the other hand, interestingly, it also emerged that some Italian hospitals still include obsolete o redundant tests in panels of urgent laboratory analyses, potentially misleading for the diagnostic reasoning in the Emergency Department (ED). In conclusion, the virtuous circle between EM and LM should be further reinforced for optimizing clinical pathways in Italian EDs, improving clinical outcomes and reducing unnecessary expenditures. A major agreement between laboratory and emergency professionals

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