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Query: UMLS:C1291077 (bloating)
 1,674 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The paper by Sperber et al. in this issue is an early evaluation of the Rome III criteria against the Rome II criteria for irritable bowel syndrome that throws up several important observations. A three to four-fold increase was observed in irritable bowel syndrome prevalence with the Rome III criteria. Individuals with the Rome II criteria had more doctor visits, perception of stress and a negative global feeling. There could be a shift of individuals between irritable bowel syndrome and other functional bowel disorder diagnostic groups such as functional constipation and functional bloating. In this review, it is suggested that rigid application of the symptom frequency and duration requirements of the older Rome criteria could have introduced a selection bias for patients with greater psychological disturbance, and that this could have impacted negatively on our perception and management of irritable bowel syndrome. The findings of Sperber et al. suggest that the new Rome III criteria may enable us to pay more attention to the average irritable bowel syndrome patient we see in our clinics as opposed to the chronically severe patient. It is proposed that improved management of our average patient may translate into better outcomes in terms of reduction in specialist referral, unnecessary surgery and potentially harmful alternative treatments.
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PMID:Irritable bowel syndrome and the Rome III criteria: for better or for worse? 1748 53

In this review we have unearthed epidemiological data that; support the 'old' concept of irritable bowel syndrome (IBS) as a disorder of civilization, build a 'new' symptom profile of IBS for Asia, and persuade us against the use of 'borrowed' Western diagnostic criteria and illness models by Asian societies. In the 1960s, IBS was described as a disorder of civilization. Early studies from Asia suggested a prevalence of IBS below 5%. Recent studies from Asia suggest a trend for the more affluent city states like Singapore and Tokyo, to have higher prevalence of 8.6% and 9.8%, respectively, while India had the lowest prevalence of 4.2%. Furthermore, there was a trend among the better educated and more affluent strata of society in several urban Chinese populations for a higher prevalence of IBS, as well as a trend for a higher consultation rate. Across Chinese and Indian predominant populations, a majority of patients with IBS criteria report upper abdominal symptoms such as epigastric pain relieved by defecation, bloating and dyspepsia. Bloating and incomplete evacuation appear to be more important determinants of consultation behavior, than psychological factors. The failure of the Rome criteria to recognize the relationship to meals, may have led to a substantial misclassification of IBS as dyspepsia. The relevance of the Western model of psychological disturbance as a determinant of consultation behavior is questionable because of the accessibility and acceptability of medical consultation for gastrointestinal complaints in many Asian communities.
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PMID:Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. 1978 1