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Diagnosis of functional constipation: Agreement between R ome III and R ome II criteria and evaluation for the practicality
Author(s) -
Xin Hai Wei,
Fang Xiu Cai,
Zhu Li Ming,
Xu Tao,
Fei Gui Jun,
Wang Zhi Feng,
Chang Min,
Wang Li Ying,
Sun Xiao Hong,
Ke Mei Yun
Publication year - 2014
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12145
Subject(s) - constipation , medicine , functional constipation , chronic constipation , defecation , gastroenterology , kappa , defecography , linguistics , philosophy
Objective To investigate the agreement between R ome III and R ome II criteria for diagnosing functional constipation ( FC ) and to evaluate the accuracy of each constipation symptom for FC diagnosis. Methods Patients with chronic constipation underwent rigorous biochemical and endoscopic/imaging tests to exclude organic and metabolic diseases. The questionnaires including general information, constipation symptoms, and the most troublesome constipation symptoms were completed in a face‐to‐face survey. The accuracy of constipation symptoms for FC diagnosis was examined using the likelihood ratio. Results Among 184 patients (43 males and 141 females) with chronic constipation, 166 (90.2%) met R ome II criteria and 174 (94.6%) met R ome III criteria for FC, while 166 met both criteria. There was a good diagnostic agreement between the two sets of criteria, with a kappa value of 0.69 and the overall agreement rate was 95.7% ( P < 0.001). Based on R ome III criteria, the most accurate symptom for FC diagnosis was sensation of anorectal blockage, followed by straining during defecation and infrequent bowel movements. The most troublesome symptoms reported by patients were lumpy or hard stools, straining during defecation, sensation of incomplete evacuation. More patients indicated that ‘the symptoms in the past 3 months’ was better than ‘those within the past one year’ to reflect their constipation (36.7% vs 6.0%, P < 0.001). Conclusions There is good agreement between R ome III and R ome II criteria for FC diagnosis. R ome III criteria are more practical than R ome II criteria for C hinese patients.