Functional gastrointestinal disorders in eating disorder patients: Altered distribution and predictors using ROME III compared to ROME II criteria

AIM: To compare the prevalence of Functional gastrointestinal disorders (FGIDs) using ROME. and ROME. and to describe predictors of FGIDs among eating disorder (ED) patients. METHODS: Two similar cohorts of female ED in-patients, aged 17-50 years, with no organic gas-trointestinal or systemic disorders, completed either the ROME. (n = 100) or the ROME. (n = 160) questionnaire on admission for ED treatment. The two ROME cohorts were compared on continuous demographic variables (e. g., age, BMI) using Student's t -tests, and on categorical variables (e. g., ED diagnosis) using. X-2-tests. The relationship between ED diagnostic subtypes and FGID categories was explored using. X-2-tests. Age, BMI, and psychological and behavioural predictors of the common (prevalence greater than 20%) ROME. FGIDs were tested using logistic regression analyses. RESULTS: The criteria for at least one FGID were fulfilled by 83% of the ROME. cohort, and 94% of the ROME. cohort. There were no significant differences in age, BMI, lowest ever BMI, ED diagnostic subtypes or ED-related quality of life (QOL) scores between ROME. and ROME. cohorts. The most prevalent FGIDs using ROME. were postprandial distress syndrome (PDS) (45%) and irritable bowel syndrome (IBS) (41%), followed by unspecified functional bowel disorders (U-FBD) (24%), and functional heartburn (FH) (22%). There was a 29% or 46% increase (depending on presence or absence of cyclic vomiting) in functional gastroduodenal disorders because of the introduction of PDS in ROME. compared to ROME.. There was a 35% decrease in functional bowel disorders (FBD) in Rome. (excluding U-FBD) compared to ROME.. The most significant predictor of PDS was starvation (P = 0.008). The predictor of FH (P = 0.021) and U-FBD (P = 0.007) was somatisation, and of IBS laxative use (P = 0.025). Age and BMI were not significant predictors. The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROME. added precision to many FGIDs. CONCLUSION: ROME. confers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting. Psychological factors appear to be more influential in ROME. than ROME III. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.