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. 2009 Oct 20;8(2):129.
doi: 10.1016/j.cgh.2009.10.009. Epub 2009 Oct 20.

Do the Symptom-Based, Rome Criteria of Irritable Bowel Syndrome Lead to Better Diagnosis and Treatment Outcomes? The Con Argument

Michael Camilleri  1
Affiliations

Do the Symptom-Based, Rome Criteria of Irritable Bowel Syndrome Lead to Better Diagnosis and Treatment Outcomes? The Con Argument

Michael Camilleri. Clin Gastroenterol Hepatol. .

Abstract

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.

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References

    1. Quigley EM. The ‘con’ case. The Rome process and functional gastrointestinal disorders: the barbarians are at the gate! Neurogastroenterol Motil. 2007;19:793–7. - PubMed
    1. Halder SL, Locke GR, III, Schleck CD, Zinsmeister AR, Melton LJ, III, Talley NJ. Natural history of functional gastrointestinal disorders: a 12-year longitudinal population-based study. Gastroenterology. 2007;133:799–807. - PubMed
    1. Locke GR, III, Zinsmeister AR, Fett SL, Melton LJ, III, Talley NJ. Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil. 2005;17:29–34. - PubMed
    1. Wong RK, Palsson OS, Turner MJ, Levy RL, Feld AD, Von Korff M, Whitehead WE. Are functional constipation (FC) and constipation subtype irritable bowel syndrome (IBS-C) different entities when diagnosed by ROME III criteria? Gastroenterology. 2009;136(Suppl 1):A-376. - PMC - PubMed
    1. Müller-Lissner SA, Fumagalli I, Bardhan KD, Pace F, Pecher E, Nault B, Rüegg P. Tegaserod, a 5-HT(4) receptor partial agonist, relieves symptoms in irritable bowel syndrome patients with abdominal pain, bloating and constipation. Aliment Pharmacol Ther. 2001;15:1655–1666. - PubMed