Digestive Diseases and Sciences

, Volume 47, Issue 1, pp 225–235

Functional Gastrointestinal Disorders in Canada: First Population-Based Survey Using Rome II Criteria with Suggestions for Improving the Questionnaire

  • W.G. Thompson
  • E.J. Irvine
  • P. Pare
  • S. Ferrazzi
  • L. Rance
Article

Abstract

The Rome II criteria and questionnaires developed to identify functional gastrointestinal disorders have not been evaluated. Our objectives were to determine the prevalence of functional gastrointestinal disorders in Canada, compare our results with data from other published studies, assess concordance of Rome I and Rome II criteria for irritable bowel syndrome, and suggest improvements in the Rome II questionnaire. An independent research firm was employed to conduct a random digit dial national survey, inviting household members ≥18 years of age to participate in a study examining personal health issues. Subjects recruited by telephone, who agreed to participate, were mailed a questionnaire, and the data were retrieved by a follow-up phone call. The Rome II questionnaire and algorithms were used and where possible Rome I algorithms were also applied. At least one functional gastrointestinal disorder occurred in 61.7% of 1149 respondents (65.6% female versus 57.6% male; P < 0.05). The most prevalent were the functional bowel disorders at 41.6% followed by esophageal disorders at 28.9%. Irritable bowel syndrome prevalence by Rome II and I criteria were 12.1% and 13.5%, respectively (kappa = 0.76). Because the Rome II criteria have added exclusion items that are not present in the Rome I criteria, the prevalence of esophageal, gastroduodenal, and anorectal disorders is lower than the figures from a US market survey. In conclusion, functional gastrointestinal disorders are highly prevalent in Canada, with a significantly higher rate in women. There is substantial agreement between Rome I and Rome II criteria for irritable bowel syndrome. Rome criteria and questionnaire remain works in progress.

Rome criteria Rome I Rome II functional gastrointestinal disorders irritable bowel syndrome IBS questionnaire 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Stewart WF, Liberman JM, Sandler RS, Woods, MS, Stemhagen A, Lipton RB, Farup CE: Epidemiology of constipation (EPOC) Study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol 94:3530–3540, 1999Google Scholar
  2. 2.
    Drossman DA, Li Z, Andruzzi E, Temple R, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E, Richter JE, Koch GG: US householder survey of functional gastrointestinal disorders: Prevalence, sociodemography and health impact. Dig Dis Sci 38:1569–1580, 1993Google Scholar
  3. 3.
    Thompson WG, Heaton KW: Functional bowel disorders in apparently healthy people. Gastroenterology 79:283–288, 1980Google Scholar
  4. 4.
    Drossman DA, Sandler RS, McKee DC, Lovitz AJ: Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 83:529–534, 1982Google Scholar
  5. 5.
    Bommelaer G, Rouch M, Dapoigny M, Pais D, Loisy P, Gualino R, Tournut R: tEpidemiologie des troubles fonctionnels dans une population apparement saine. Gastroenterol Clin Biol 10:7–12, 1986Google Scholar
  6. 6.
    Welch GW, Pomare EW: Functional gastrointestinal symptoms in a Wellington community sample. NZ Med J 103:418–420, 1990Google Scholar
  7. 7.
    Bi-zhen W, Qi-Ying P: Functional bowel disorders in apparently healthy chinese people. Chin J Epidemiol 9:345–349, 1988Google Scholar
  8. 8.
    Manning AP, Thompson WG, Heaton KW, Morris AF: Towards positive diagnosis of the irritable bowel. Br Med J 2:653–654, 1978Google Scholar
  9. 9.
    Heaton KW, O'Donnell LJD, Braddon FEM, Mountford RA, Hughes AO, Cripps PJ: Symptoms of irritable bowel syndrome in a British urban community: Consulters and nonconsulters. Gastroenterology 102:1962–1967, 1992Google Scholar
  10. 10.
    Thompson WG, Creed FH, Drossman DA, Heaton KW, Mazzacca G: Functional bowel disorders and functional abdominal pain. Gastroenterol Int 5:75–91, 1992Google Scholar
  11. 11.
    Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA: Functional bowel disease and functional abdominal pain. Gut 45(suppl II):43–47, 1999Google Scholar
  12. 12.
    Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE: Appendix B. The Rome II Modular Questionnaire. In The Functional Gastrointestinal Disorders. Drossman DA, Corazziari, J Talley, WG Thompson, WE Whitehead, ed. McLean Virginia; Degnon, 2000; pp 670–688Google Scholar
  13. 13.
    Anon. Interviewer CATI for Windows. http:/www.voxco.com/ html/interview.htm. 2000, VOXCOGoogle Scholar
  14. 14.
    Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA: Functional bowel disorders and functional abdominal pain. In The Functional Gastrointestinal Disorders. DA Drossman, E Corazziari, NJ Talley, WG Thompson, WE Whitehead, (ed). Washington, Degnon, 2000, pp. 351–432Google Scholar
  15. 15.
    Evans B, Crawford B: Patient self-reports in pharmacoeconomic studies: Their use and impact on on study validity. Pharmacoeconomics 15:241–256, 1999Google Scholar
  16. 16.
    Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE: The Functional Gastrointestinal Disorders, 2nd ed. McLean, Virginia, Degnon, 2000Google Scholar
  17. 17.
    Vanner SJ, Depew WT, Patterson WG, DaCosta LR, Groll AG, Simon JB, Djurfeldt M: Predictive values of the Rome criteria for diagnosing irritable bowel syndrome. Am J Gastroenterol 94:2912–2917, 1999Google Scholar
  18. 18.
    McDowell I, Newell C: Measuring Health: A Guide to Rating Scales and Questionnaires. New York; Oxford University Press, 1987Google Scholar
  19. 19.
    Camillari M, Northcutt AR, Kong S, Dukes GE, McSorley D, Mangel AW: Efficacy and safety of alosetron in women with irritable bowel syndrome: A randomised, placebo-controlled trial. Lancet 355:1035–1039, 2000Google Scholar
  20. 20.
    Lefkowitz M, Shi Y, Schmidt C, Krumholz S, Tanghe J: The partial 5HT4 agonist Tegaserod, improves abdominal discomfort/pain and normalizes altered bowel function in irritable bowel syndrome (IBS). Am J Gastroenterol 94(A396):2676, 1999Google Scholar
  21. 21.
    Mertz H, Naliboff B, Munakata J, Niazi N, Meyer EA: Altered rectal perception is a biological marker of patients with irritable bowel syndrome. Gastroenterology 109:40–52, 1995Google Scholar
  22. 22.
    Levy RL, Whitehead WE, Von Korff MR, Feld AD: Intergenerational transmission of gastrointestinal illness behavior. Am J Gastroenterol 95:451–456, 2000Google Scholar
  23. 23.
    Vanner S, Glenn D, Patterson WG, Depew W, Mackenzie T, Djurfeldt M, DeCosta LR, Groll AG, Simon JB: Diagnosing irritable bowel syndrome: Predictive value of the Rome criteria. Gastroenterology 112:A47, 1997Google Scholar
  24. 24.
    Hamm LR, Sorrells SC, Harding JP, Northcutt AR, Heath AT, Kapke GF, et al: Additional investigations fail to alter the diagnosis of irritable bowel syndrome in subjects fulfilling the Rome criteria. Am J Gastroenterol 94:1279–1282, 1999Google Scholar
  25. 25.
    Drossman DA: Appendix A. Research diagnostic questions for functional gastrointestinal disorders. In DA Drossman, JE Richter, NJ Talley, WG Thompson, E Corazziari, WE Whitehead, ed. The Functional Gastrointestinal Disorders. McLean Virginia, Degnon, 2000, pp 339–346Google Scholar
  26. 26.
    Taub E, Cuevas JL, Cook EW, Crowell MD, Whitehead WE. Irritable bowel syndrome defined by factor analysis. Dig Dis Sci 40:2647–2655, 1995Google Scholar
  27. 27.
    Whitehead WE, Crowell MD, Bosmajian L, Zonderman A, Costa PT Jr, Benjamin C, Robinson JC, Heller BR, Schuster MM: Existence of irritable bowel syndrome supported by factor analysis of symptoms in two community samples. Gastroenterology 98:336–340, 1990Google Scholar
  28. 28.
    Thompson WG: Gender differences in irritable bowel symptoms. Eur J Gastroenterol Hepatol 9:299–302, 1997Google Scholar
  29. 29.
    Probert CSJ, Emmett PM, Cripps HA, Heaton KW. Evidence for the ambiguity of the word constipation: The role of irritable bowel syndrome. Gut 35:1455–1458, 1994Google Scholar
  30. 30.
    Sandler RS, Jordan MC, Shelton BJ: Demographic and dietary determinants of constipation in the US population. Am J Public Health. 80(2):185–189, 1990Google Scholar
  31. 31.
    Thompson WG: The road to Rome. In The Functional Gastrointestinal Disorders: Diagnosis, Pathopyhsiology and Treatment: A Multinational Consensus. DA Drossman, E Corazziari, NJ Talley, WG Thompson, WE Whitehead, (eds). McLean, Virginia, Degnon, 2000; pp 629–635Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • W.G. Thompson
    • 1
  • E.J. Irvine
    • 2
  • P. Pare
    • 3
  • S. Ferrazzi
    • 4
  • L. Rance
    • 4
  1. 1.University of OttawaOttawaCanada
  2. 2.McMaster UniversityHamiltonCanada
  3. 3.Laval UniversityQuebec CityCanada
  4. 4.Health Economics, Janssen-Ortho Inc.TorontoCanada

Personalised recommendations