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Irritable Bowel Syndrome Subtypes Defined by Rome II and Rome III Criteria are Similar

Dorn, Spencer D., MD, MPH* †; Morris, Carolyn B., MPH*; Hu, Yuming, PhD*; Toner, Brenda B., PhD; Diamant, Nicholas, MD§; Whitehead, William E., PhD* †; Bangdiwala, Shrikant I., PhD*; Drossman, Douglas A., MD* †

Journal of Clinical Gastroenterology: March 2009 - Volume 43 - Issue 3 - p 214-220
doi: 10.1097/MCG.0b013e31815bd749
ALIMENTARY TRACT: Clinical Research
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Background The implications of the Rome III recommendations to change the irritable bowel syndrome (IBS) subtype criteria for stool pattern are unknown.

Aim (1) Determine the level of agreement between Rome II and Rome III subtypes and (2) compare the behaviors of Rome II and Rome III subtypes over time.

Methods Female patients (n=148) with Rome II defined IBS were prospectively tracked over 5 consecutive 3-month periods. At baseline, bowel habit reports on questionnaires were used to subclassify patients into Rome II and Rome III subtypes. Over the subsequent 15 months, bowel habit reports on diary cards were used to subclassify patients based on previously derived surrogate criteria into Rome II and Rome III IBS subtypes.

Results The level of agreement between Rome II and Rome III subtype assignments was quite high (86.5%; κ 0.79). The behavior of Rome II and Rome III subtypes over time was also similar in terms of subtype prevalence, subtype stability, and the proportion of subjects who met criteria for alternating irritable bowel syndrome.

Conclusions Rome II and Rome III IBS subtypes are in high agreement and behave similarly over time. Therefore, studies that used Rome II subtype criteria and studies that will use Rome III criteria will define comparable populations.

*UNC Center for Functional GI and Motility Disorders

Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC

Centre for Addiction and Mental Health

§Gastroenterology Division, Department of Medicine, University of Toronto, Ontario, Canada

The authors declare no conflict of interest.

Supported by National Institutes of Health grants R01DK49334, R24 DK067674, and T32 DK7634, GCRC 00024, and Novartis Pharmaceuticals.

Reprints: Dr Douglas A. Drossman, MD, UNC Center for Functional GI and Motility Disorders, University of North Carolina, 130 Mason Farm Road CB7080, Chapel Hill, NC 27599-7080 (e-mail: drossman@med.unc.edu).

Received for publication July 17, 2007; accepted September 21, 2007

© 2009 Lippincott Williams & Wilkins, Inc.