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Rome II Criteria (rome + ii_criterion)
Selected AbstractsFunctional gastrointestinal disorders and visceral hypersensitivity in children and adolescents suffering from Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 11 2008Christophe Faure MD Abstract Background: Symptoms of abdominal pain are reported by children with active Crohn's disease (CD). During remissions abdominal pain improves in most children but some of them continue to experience pain. We hypothesized that these patients may suffer from protracted abdominal pain related to functional gastrointestinal disorders (FGID) and visceral hypersensitivity. The objective was to characterize the symptoms and to measure the rectal sensory threshold for pain (RSTP) by barostat in CD children and adolescents suffering from abdominal pain despite remission. Methods: Eight patients (median age 14.5 years; range 9.8,17) with quiescent CD but suffering from chronic abdominal pain were studied by rectal barostat. At the same time they completed validated questionnaires to assess FGID, anxiety, and depression. They were compared to 10 control children and 8 children with FGID also investigated in our laboratory. Results: All patients fulfilled Rome II criteria for irritable bowel syndrome (n = 5), functional abdominal pain (n = 2), and functional dyspepsia (n = 1). RSTP was significantly lower in CD patients compared to the normal controls: median (range) 25 mmHg (15,29) versus 40 mmHg (30,48) (P < 0.01). RSTP was similar in patients and children with FGID. Rectal compliance was similar in patients, children with FGID, and controls. Seven of the 8 patients had scores indicating an anxiety problem. Conclusions: Protracted abdominal pain that affects children and adolescents with quiescent CD is related to FGID associated with visceral hypersensitivity and anxiety. The incidence of FGID in children suffering from CD requires further investigation. (Inflamm Bowel Dis 2008) [source] The epidemiological aspects of irritable bowel syndrome in Southeastern Anatolia: a stratified randomised community-based studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2005erif Yilmaz Summary Even though studies on the epidemiology of the irritable bowel syndrome (IBS) are increasing day by day, epidemiological data are still unknown in many regions. Our objective was to determine the IBS prevalence, factors associated with this prevalence and probable risk groups in Southeastern Anatolia. The total population in the target region is approximately 6 million. A total of 3000 people (1521 females and 1479 males) randomly selected by stratified cluster sampling were interviewed face-to-face by using a questionnaire comprising demographic features and the Rome II criteria which also included probable risk factors and questions related with Bristol scale stool form. The statistical analysis was performed by using a package program called epi info 2000. IBS prevalence was 10.2% according to the Rome II criteria in our region. Six hundred and twenty-five of 3000 subjects had gastrointestinal symptoms in the last 3 months. IBS rate was higher in women (12.4%) than in men (8.0%), and married subjects had higher IBS rates (11.6%) than singles (6.7%). Those differences were statistically significant (p = 0.000 for both). It was most common in the 35,54-year age group. No difference was observed in terms of settlement (rural/urban), age group, education and occupation. History of abortion in women increased the IBS risk by 1.8 times (p = 0.000 Crude odds ratios = 1.8 (1.3,2.6) 95% confidence intervals). Of the IBS patients, 48.1% had characteristics of diarrhoea-predominance, 38.9% constipation-predominance while 13.0% had none. There was a significant relation between dominant stool form and Bristol scale stool form. IBS prevalence is 10.2% in the first community-based study carried out in this specific subject in Southeastern Anatolia. The dominance of middle age and females remained significant. [source] Irritable bowel syndrome in the 21st century: Perspectives from Asia or South-east AsiaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2007Full-Young Chang Abstract Asian irritable bowel syndrome (IBS) studies not only confirm the truth of this functional disorder but also describe the current disease situation of this continent, with its variable socioeconomic backgrounds. Most Asian community IBS prevalence is within 5,10%, regardless of gender or ethnic character. As well as meeting the main Rome II criteria, Asian IBS subjects also have many minor symptoms. Thus this recommendation remains useful to diagnose Asian IBS. Also, female patients commonly express constipation-predominant (C-) symptoms. Extra-colonic symptoms are common in Asia, for example dyspepsia, insomnia and irritable urinary bladder. Asian IBS subjects do experience psychological disturbances including anxiety, depression, agoraphobia and neuroticism. Accordingly, their quality of life is poor and there is absenteeism leading to excessive physician visits. Abnormal gut motor and sensory functions have been indicated among the Asian IBS subjects. Now, there is evidence of altered colonic neuroimmune function leading to gut hypersensitivity and dysmotility. An Asia,Pacific trial also confirmed tegaserod efficacy on female C-IBS subjects. More than 90% of nurses have very limited IBS knowledge, and are unable even to explain it clearly. In conclusion, Western recommended criteria clearly diagnose Asian IBS and many factors are mutual leading to IBS. Current IBS treatments remain useful but additional reeducation for medical professionals appears to be needed. [source] Visceral perception thresholds after rectal thermal and pressure stimuli in irritable bowel syndrome patientsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2004YANQING LI Abstract Background and Aim:, Visceral hypersensitivity has been shown to be present in irritable bowel syndrome (IBS). The current study sought to compare the characteristics of visceral perception thresholds after rectal thermal and pressure stimuli between IBS patients and healthy subjects. Methods:, A total of 46 patients with IBS were diagnosed using Rome II criteria. Thirteen healthy individuals participated in the study. Rectal visceral perception thresholds were examined in patients with IBS and in normal controls after thermal and pressure stimuli. Subjects were asked to report the sensation type, location, and spread. Results:, Compared with healthy subjects, IBS patients demonstrated significantly initially lower perception thresholds and defecation thresholds to rectal thermal and pressure stimuli, particularly in patients with diarrhea-predominant IBS. Ice stimuli on the abdominal wall had varied effects on symptoms in patients with IBS and did not affect perception thresholds. Conclusions:, Visceral perception thresholds were decreased significantly after rectal thermal and pressure stimuli in patients with IBS. Visceral hypersensitivity may be one of the important pathogenic mechanisms in IBS. [source] Impact of the Rome II paediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in childrenALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2010E. Miele Aliment Pharmacol Ther 2010; 32: 582,590 Summary Background, The demand for paediatric gastrointestinal (GI) endoscopy has increased, resulting in a significant rise of overall costs. Aim, To assess the clinical impact of the Rome II criteria for functional gastrointestinal disorders when selecting paediatric patients who underwent GI endoscopy. Methods, The indications and findings of GI endoscopic procedures performed before and after the publication of the Rome II criteria were evaluated retrospectively. Results, Upper GI endoscopy was performed in 1124 children, whereas colonoscopy was performed in 500 subjects. A total of 607 (54%) oesophago-gastro-duodenoscopies (OGDs) were positive and 517 (46%) were negative, whereas 306 (61.1%) colonoscopies were positive and 194 (38.9%) were negative. Of the 1624 procedures, 26% were considered inappropriate according to the Rome II criteria. Inappropriate procedures decreased significantly after publication of the Rome II criteria (OR, 3.7; 95% CI, 1.8,7.5). Of 1202 appropriate GI endoscopies, 502 OGD (62.7%) were significantly contributive, compared with only 105 (32.5%) of the 323 inappropriate procedures (OR, 3.5; 95% CI, 2.6,4.6), whereas 265 (65.8%) colonoscopies were significantly contributive, compared with only 41 (42.3%) of the 97 inappropriate procedures (OR, 2.6; 95% CI, 1.6,4.1). Conclusions, The use of the criteria for functional gastrointestinal disorders makes a significant positive impact, they should reduce unnecessary paediatric GI endoscopy. [source] Clinical trial: the glucagon-like peptide-1 analogue ROSE-010 for management of acute pain in patients with irritable bowel syndrome: a randomized, placebo-controlled, double-blind studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2009P. M. HELLSTRÖM Summary Background, There is currently no treatment available to manage acute pain attacks in IBS patients regardless of subtype. Aims, To evaluate efficacy and safety of the GLP-1 analogue ROSE-010 in patients with irritable bowel syndrome (IBS) through a randomized, double-blind, placebo-controlled study. Methods, Eligible patients (n = 166) meeting Rome II criteria were randomly assigned to receive single subcutaneous injections of ROSE-010 100 ,g, 300 ,g and placebo in a cross-over design. Safety was assessed from spontaneously reported adverse events and measurement of vital signs. Patient-rated pain relief and intensity were measured on a 100-mm visual analogue scale. The primary efficacy variable was proportion of patients with >50% maximum total pain relief response from 10 to 60 min after treatment. Secondary endpoints included the maximum summed pain intensity difference, time to meaningful pain relief and patient ratings of satisfaction with treatment. Results, Twice as many patients were responders in the primary efficacy endpoint after both ROSE-010 injections compared to placebo (24%P = 0.011, 23%P = 0.005, and 12% after 300 ,g, 100 ,g and placebo injections, respectively). Similar results were obtained for the proportion of patients with total pain intensity response. Times to meaningful and total pain relief were shorter for both doses of ROSE-010 compared with placebo. Compared with placebo, more patients (P < 0.05) were satisfied with ROSE-010 and considered ROSE-010 better than previous IBS medications used. Conclusion, ROSE-010 was well tolerated and provided fast and effective relief of acute pain attacks on demand in IBS patients. [source] Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009E. A. WILLIAMS Summary Background, The efficacy of probiotics in alleviating the symptoms of irritable bowel syndrome (IBS) appears to be both strain- and dose-related. Aim, To investigate the effect of LAB4, a multistrain probiotic preparation on symptoms of IBS. This probiotic preparation has not previously been assessed in IBS. Methods, Fifty-two participants with IBS, as defined by the Rome II criteria, participated in this double blind, randomized, placebo-controlled study. Participants were randomized to receive either a probiotic preparation comprising two strains of Lactobacillus acidophilus CUL60 (NCIMB 30157) and CUL21 (NCIMB 30156), Bifidobacterium lactis CUL34 (NCIMB 30172) and Bifidobacterium bifidum CUL20 (NCIMB 30153) at a total of 2.5 × 1010 cfu/capsule or a placebo for 8 weeks. Participants reported their IBS symptoms using a questionnaire fortnightly during the intervention and at 2 weeks post-intervention. Results, A significantly greater improvement in the Symptom Severity Score of IBS and in scores for quality of life, days with pain and satisfaction with bowel habit was observed over the 8-week intervention period in the volunteers receiving the probiotic preparation than in the placebo group. Conclusion, LAB4 multistrain probiotic supplement may benefit subjects with IBS. [source] Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiotaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2008K. KAJANDER Summary Background, Irritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial. Aim, To investigate the effects of multispecies probiotic supplementation (Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12) on abdominal symptoms, quality of life, intestinal microbiota and inflammatory markers in irritable bowel syndrome. Methods, Eighty-six irritable bowel syndrome patients (Rome II criteria) participated in this randomized, placebo-controlled 5-month intervention. Patients were randomized to receive daily either multispecies probiotic supplementation or placebo. Irritable bowel syndrome symptoms, quality of life, microarray-based intestinal microbiota stability (n = 20), serum cytokines and sensitive C-reactive protein were monitored. Results, The composite irritable bowel syndrome score had at 5 months decreased 14 points (95% CI: ,19 to ,9) from baseline with the multispecies probiotic vs. three points (95% CI: ,8 to 1) with placebo (P = 0.0083). Especially, distension and abdominal pain were affected. A stabilization of the microbiota was observed, as the microbiota similarity index increased with the probiotic supplementation (1.9 ± 3.1), while it decreased with placebo (,2.9 ± 1.7). No differences were seen in C-reactive protein. Conclusions, This multispecies probiotic seems to be an effective and safe option to alleviate symptoms of irritable bowel syndrome, and to stabilize the intestinal microbiota. [source] Irritable bowel syndrome: patients' attitudes, concerns and level of knowledgeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2007B. E. LACY Summary Background Irritable bowel syndrome (IBS) is a common, chronic disorder that reduces patients' quality-of-life. Although highly prevalent, little is known about patients' understanding of this disorder. Aim To evaluate the knowledge, fears and concerns of IBS patients. Methods Seven hundred thirty-six IBS patients (Rome II criteria) were eligible for inclusion in this prospective study. Each patient received a validated questionnaire to evaluate knowledge, attitudes and fears regarding IBS. Results A total of 261 of 664 potential respondents completed the questionnaire (39.3%). 83% of respondents were women, with a mean age of 53.7 years, and mean duration of symptoms of 14.2 years. Patients frequently believed that IBS develops because of anxiety (80.5%), dietary factors (75.1%) and depression (63.2%). Few respondents (28.7%) recognized that abdominal pain is the cardinal symptom of IBS, and 40.6% stated that colonoscopy can diagnose IBS. One in seven patients stated that IBS turns into cancer, and 29.9% noted that IBS increases the risk of inflammatory bowel disease. Conclusions Many IBS patients have significant misconceptions regarding the nature of their disease and its prognosis. An overwhelming majority of IBS patients believe that anxiety, dietary factors and depression cause IBS. These findings are discordant with physicians' views and practices and highlight the need for patient-oriented educational programs. [source] Predictors of the placebo response in functional dyspepsiaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2006N. J. TALLEY Summary Background, Trials in functional dyspepsia report placebo response rates of 30% to 40%. Aim, We aimed to identify predictors of the placebo response. Methods, Patients from primary, secondary and tertiary practices with functional dyspepsia defined by Rome II criteria were enrolled into one of four clinical trials; 220 patients were randomized to receive placebo. Scintigraphic assessment of gastric emptying at baseline was repeated at the end of the treatment in those with delayed emptying. After a 2 week run-in period, patients were followed for 8 weeks on placebo. Response was assessed on a weekly basis and a responder was defined as satisfactory relief of meal-related symptoms on at least 50% of weeks. Results, The mean age was 44 years (range 18,82) and 74% were female; 76 (35%) were placebo responders. The predominant symptom was an unstable measure over the trial. Independent predictors of a lower placebo response were lower body mass index and a more consistent predominant symptom pattern (both P < 0.05). No association was seen with age, gender, centre type, baseline symptom score, baseline or change in gastric emptying, or baseline quality of life. Conclusion, In functional dyspepsia, a consistent predominant symptom pattern and lower body mass index may be associated with a lower placebo response rate. [source] A population-based epidemiologic study of irritable bowel syndrome in South China: stratified randomized study by cluster samplingALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2004L. S. Xiong Summary Background :,The detailed population-based data on irritable bowel syndrome in South China are lacking. Aims :,To assess the prevalence of irritable bowel syndrome in South China and its impact on health-related quality of life. Subjects and methods :,A face-to-face interview was carried out in South China to assess the prevalence of irritable bowel syndrome. Random clustered sampling of permanent inhabitants aged 18,80 years was carried out under stratification of urban and suburban areas. The impact of irritable bowel syndrome on health-related quality of life was evaluated using the Chinese version of SF-36. Results :,A total of 4178 subjects (1907 male and 2271 female) were interviewed. The adjusted prevalence of irritable bowel syndrome in South China is 11.50% according to the Manning criteria and 5.67% according to the Rome II criteria. Factors including history of analgesic use such as non-steroidal anti-inflammatory drug (odds ratio 3.83), history of food allergies (odds ratio 2.68), psychological distress (odds ratio 2.18), life events (odds ratio 1.89), history of dysentery (odds ratio 1.63) and negative coping style (odds ratio 1.28) were significantly associated with the presence of irritable bowel syndrome (P < 0.05). Irritable bowel syndrome was significantly associated with a decrement in health-related quality of life score. Conclusion :,Irritable bowel syndrome is a common disorder in South China and has a negative impact on health-related quality of life. [source] Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation,Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease,MOVEMENT DISORDERS, Issue 5 2009Marian L. Evatt MD Abstract Upper and lower gastrointestinal dysautonomia symptoms (GIDS),sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time-consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated "Recommended" if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. "Suggested" scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS-PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia-Specific Quality of Life (SWAL-QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD-Autonomic (SCOPA-AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal-related dysautonomia in PD. Only two scales met "Recommended" criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society [source] The effect of new diagnostic criteria for irritable bowel syndrome on community prevalence estimatesNEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2003Y. A. Saito Abstract, The ,Rome' criteria for irritable bowel syndrome (IBS) have evolved over 15 years with four published versions. The impact of these changes on community prevalence rates is not known. Study aims were to estimate the prevalence of IBS using the four Rome criteria and agreement between Rome II and previous criteria. Questionnaires were mailed to a random sample of Olmsted County, Minnesota residents in 1992. Age- and gender-adjusted prevalence estimates were calculated for Rome II (1999), Rome I (1992), Rome (1990), and Rome (1989) criteria. Per cent agreement and kappa values were calculated to assess agreement. Of 892 eligible subjects, 643 (72%) responded. The age- and gender-adjusted prevalence of IBS was 5.1% [95% confidence interval (CI): 3.1, 7.0], 6.8% (95% CI: 4.7, 8.9), 5.1% (95% CI: 3.2, 7.1) and 27.6% (95% CI: 23.6, 31.5), respectively. In comparison with Rome II criteria, per cent agreement and , values were 97.2% and 0.78 (95% CI: 0.69, 0.88), 96.4% and 0.68 (95% CI: 0.55, 0.80), and 79.0% and 0.29 (95% CI: 0.19, 0.40), respectively. Thus, although differences were seen with the older criteria, compared with the Rome I criteria, good agreement was seen and community prevalence estimates were similar with the Rome II criteria. [source] | ||||||||||