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Cited by 204Gastrointestinal motility and disordersPelvic floor disorders treatmentsCongenital gastrointestinal and neural anomalies

The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.

Inability of the Rome III Criteria to Distinguish Functional Constipation From Constipation-Subtype Irritable Bowel Syndrome

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Wong, Reuben K, Palsson, Olafur S, Turner, Marsha J, Levy, Rona L, Feld, Andrew D, von Korff, Michael, Whitehead, William E·2010·American Journal of Gastroenterology
DOI 10.1038/ajg.2010.200PMC PMC3786710
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Abstract

OBJECTIVES: The Rome III classification system treats functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) as distinct disorders, but this distinction appears artificial, and the same drugs are used to treat both. This study's hypothesis is that FC and IBS-C defined by Rome III are not distinct entities. METHODS: In all, 1,100 adults with a primary care visit for constipation and 1,700 age- and gender-matched controls from a health maintenance organization completed surveys 12 months apart; 66.2% returned the first questionnaire. Rome III criteria identified 231 with FC and 201 with IBS-C. The second survey was completed by 195 of the FC and 141 of the IBS-C cohorts. Both surveys assessed the severity of constipation and IBS, quality of life (QOL), and psychological distress. RESULTS: (i) Overlap: if the Rome III requirement that patients meeting criteria for IBS cannot be diagnosed with FC is suspended, 89.5% of IBS-C cases meet criteria for FC and 43.8% of FC patients fulfill criteria for IBS-C. (ii) No qualitative differences between FC and IBS-C: 44.8% of FC patients report abdominal pain, and paradoxically IBS-C patients have more constipation symptoms than FC. (iii) Switching between diagnoses: by 12 months, 1/3 of FC transition to IBS-C and 1/3 of IBS-C change to FC. CONCLUSIONS: Patients identified by Rome III criteria for FC and IBS-C are not distinct groups. Revisions to the Rome III criteria, possibly including incorporation of physiological tests of transit and pelvic floor function, are needed.

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Metadata

Authors
Wong, R. K., Palsson, O. S., Turner, M. J., Levy, R. L., Feld, A. D., von Korff, M., & Whitehead, W. E.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • University of Washington (US)
  • Group Health Cooperative (US)
Corresponding author
Whitehead, William E
ORCID
Venue
American Journal of Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-10
Volume
105
Issue
10
Pages
2228-2234
ISSN
0002-9270 (ISSN-L)
DOI
10.1038/ajg.2010.200
PMC
PMC3786710
OpenAlex
W2051262240
Cited by
204
References
17
Citations by year
2026: 5 · 2025: 10 · 2024: 5 · 2023: 3 · 2022: 11 · 2021: 14 · 2020: 20 · 2019: 14 · 2018: 13 · 2017: 15 · 2016: 20 · 2015: 16 · 2014: 20 · 2013: 13 · 2012: 11
FWCI
11.85
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • The American Journal of Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK031369, R24DK067674)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
Keywords
functional constipation, irritable bowel syndrome with constipation, Rome III criteria, diagnostic classification, diagnostic overlap, disease transition, quality of life, psychological distress, abdominal pain, primary care
MeSH terms
Adult, Aged, Constipation, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Surveys and Questionnaires, Patient Selection, Statistics, Nonparametric, Irritable Bowel Syndrome

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