Prevalence of Rome IV Functional Bowel Disorders Among Adults in the United States, Canada, and the United Kingdom.

Published on Apr 1, 2020in Gastroenterology17.373
· DOI :10.1053/J.GASTRO.2019.12.021
Olafur S. Palsson50
Estimated H-index: 50
(UNC: University of North Carolina at Chapel Hill),
William E. Whitehead102
Estimated H-index: 102
(UNC: University of North Carolina at Chapel Hill)
+ 2 AuthorsMagnus Simrén78
Estimated H-index: 78
(UNC: University of North Carolina at Chapel Hill)
Abstract Background & Aims Little is known about the population prevalence or demographic distributions of Rome IV functional bowel disorders (FBDs) or their effects on quality of life. We examined these in a multi-national survey. Methods We analyzed data from a population-based survey of adults in the United States, Canada, and United Kingdom (5931 valid responders; 49.2% female; mean age, 47.4 years; range, 18–92 years). The survey included the Rome IV Diagnostic Questionnaire, Rome III irritable bowel syndrome (IBS) and constipation questions, and the SF-8 quality of life questionnaire. Results The prevalence values of census-adjusted Rome IV FBDs were similar among the 3 countries; ranges were: 4.4%–4.8% for IBS, 7.9%–8.6% for functional constipation, 3.6%–5.3% for functional diarrhea, 2.0%–3.9% for functional bloating or distention, 1.1%–1.9% for opioid-induced constipation, 7.5%–10.0% for unspecified FBDs, and 28.6%–31.7% for any Rome IV FBD. FBDs were less common in older individuals, and all except functional diarrhea were more common in women. IBS was only half as prevalent by Rome IV as by Rome III criteria (4.6% vs 9.0% overall), primarily due to higher Rome IV minimum pain frequency. Functional diarrhea and functional constipation were more prevalent by Rome IV than Rome III criteria. Subjects with FBD had significant reductions in quality of life and reported more gastrointestinal doctor consultations than other subjects. Conclusions More than one in four adults in the general population meet the Rome IV criteria for FBDs. These disorders affect quality of life and increase use of gastrointestinal healthcare. The switch from Rome III to Rome IV criteria reduces the prevalence of IBS by half, but increases the prevalence of functional constipation and functional diarrhea.
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