Stability of irritable bowel syndrome using a Rome II-based classification

Area of Science:

• Gastroenterology
• Clinical Epidemiology

Background:

• Irritable Bowel Syndrome (IBS) diagnosis relies on symptom-based criteria due to the absence of a biological marker.
• The Rome II criteria are commonly used for IBS classification.

Purpose of the Study:

• To assess the stability of self-reported symptoms used for Irritable Bowel Syndrome (IBS) classification based on Rome II criteria.
• To evaluate how consistently individuals meet IBS diagnostic criteria over a two-year period.

Main Methods:

• A population-based cohort identified with modified Rome II criteria in 2001 was re-evaluated two years later.
• Data collection utilized a web-based questionnaire to assess current symptoms and IBS classification.

Main Results:

• Only 30% of subjects maintained the same IBS subtype, while 52% no longer met IBS criteria at follow-up.
• Individuals remaining symptomatic were more likely to have the alternating IBS subtype, higher psychological impairment, and lower quality of life.
• Absence of pain was a key factor for subjects no longer meeting IBS criteria, though many still reported moderate abdominal pain.

Conclusions:

• Irritable Bowel Syndrome (IBS) is characterized by its episodic nature, with significant fluctuations in symptom presentation over time.
• Current symptom-based classification systems, including Rome II criteria, have limitations in capturing the dynamic course of IBS.