What impact do Rome IV criteria have on patients with IBS in China?

Background: The Rome criteria for functional gastrointestinal diseases (FGIDs) have been updated from Rome III to Rome IV. This study aimed to investigate the impact of the update on patients with irritable bowel syndrome (IBS) in China.Methods: A previous database including consecutive patients with FGIDs (according to Rome III criteria) from gastrointestinal department of a tertiary hospital in China was re-analyzed. Demographic information, clinical symptoms, psychological status (Zung self-rating scale), and sleep quality (Pittsburgh sleep quality index) were compared between patients with Rome III and Rome IV IBS.Results: Of the 946 patients with FGIDs, only 58 (6.1%) were diagnosed with Rome IV IBS [less than 292 (30.9%) under Rome III criteria] with a surge of the number of unspecified functional bowel disorders (U-FBD). All patients with IBS were divided into three groups: group A [meeting both Rome III and IV criteria, accounting for 43 (4.6%) of patients with FGIDs], group B [meeting only Rome III criteria, 249 (26.3%)], and group C [meeting only Rome IV criteria,15 (1.6%)]. Significant differences in frequency and severity of symptoms, subtypes, and sleep quality among groups (all p < .05) were found. Patients with Rome III IBS having sleep disorder tended to be more serious than those without. On the contrary, it was not the case under Rome IV criteria.Conclusions: Number of IBS patients was greatly reduced accompanied by a surge in U-FBD. Besides, the updated criteria also had great impacts on clinical parameters, sleep quality and psychological state of IBS patients.HighlightsRome IV criteria removed the description of abdominal discomfort for IBS.The updated Rome criteria had great impacts on IBS patients in our database.Our study analyzed the characteristics of IBS patients who fulfilled both criteria.Alterations in the Rome criteria also led to changes in the disease spectrum of FBD.