A Comparison and Validity of Various Diagnostic Criteria of Irritable Bowel Syndrome

Ji, Sang Won; Park, Hyo Jin; Lee, Jung Il; Oh, Hye Young; Lee, Sang In; Park, In Suh

Abstract

BACKGROUNDS: There has been some discordance in the prevalence of irritable bowel syndrome (IBS) probably due to different diagnostic criteria used by different study groups. The aims of this study was to determine the degree of agreement between different standard definitions and to test the validity of applying these different standards in epidemiological investigations of IBS among Korean population.
METHODS
We recruited 1,038 patients who visited Yongdong Severance Hosipital for medical checkup and gave out the prepared questionnaires. Based on the returned questionnaires, degree of agreement between Manning, Rome I, and Rome II criteria was investigated by percent agreement and calculating kappa statics. Furthermore, clinical characteristics in different definition groups and patients of self-reported IBS were investigated and compared.
RESULTS
Complete questionnaires were returned by 928 out of 1,038 subjects. The percent agreements ranged from 80.7 to 96.7 percent and kappa values ranged from 0.20 to 0.59. Best agreement occurred between Manning and Rome I criteria. Many subjects diagnosed as not having IBS by various diagnostic criteria of IBS thought themselves as having IBS. More sizable number of patients were suspected to have structural gastrointestinal diseases in IBS patients diagnosed by Manning, Rome I, and Rome II criteria compared with self-reported IBS subjects.
CONCLUSIONS
It could be suspected that results of epidemiological investigations might be different according to standard definitions applied on each studies. Furthermore, some modifications of existing standard definitions of Western world would be required before applying them among Korean population.