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Comparison of Manning, Rome I, II, and III, and Asian diagnostic criteria: Report of the Multicentric Indian Irritable Bowel Syndrome (MIIBS) study

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Attempts to diagnose and subtype irritable bowel syndrome (IBS) by symptom-based criteria have limitations, as these are developed in the West and might not be applicable in other populations.

Objectives

This study aimed to compare different criteria for diagnosing and subtyping of IBS in India.

Method

Manning's and the Rome I, II, and III criteria as well as the Asian criteria were applied to 1,618 patients (from 17 centers in India) with chronic lower gastrointestinal (GI) symptoms with no alarm features and negative investigations.

Results

Of 1,618 patients (aged 37.5 [SD 12.6] years; 71.2 % male), 1,476 (91.2 %), 1,098 (67.9 %), 649 (40.1 %), 849 (52.5 %), and 1,206 (74.5 %) fulfilled Manning's, Rome I, II, and III, and the Asian criteria, respectively. The most common reason for not fulfilling the criteria was absence of the following symptoms: “more frequent stools with onset of pain,” “loose stool with onset of pain,” “relief of pain with passage of stool,” “other abdominal discomfort/bloating,” and, in a minority, not meeting the duration criterion of 3 months/12 weeks. By stool frequency, constipation-predominant IBS (<3 stools/week) was diagnosed in 319 (19.7 %), diarrhea-predominant IBS (>3 stools/day) in 43 (2.7 %), and unclassified in 1,256 (77.6 %). By Bristol stool form, constipation, diarrhea, and unclassified were diagnosed in 655 (40.5 %), 709 (43.8 %), and 254 (15.7 %) patients, respectively. By their own perception, 462 (28.6 %), 541 (33.4 %), and 452 (27.9 %) patients reported constipation-predominant, diarrhea-predominant, and alternating types, respectively.

Conclusion

By Manning's and the Asian criteria, a diagnosis of IBS was made frequently among Indian patients with chronic functional lower GI symptoms with no alarm features; the Rome II criteria gave the lowest yield. By the stool frequency criteria, a majority of patients had unclassified pattern, unlike by the stool form and patients' perception of their symptoms.

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Acknowledgments

The task force members thank Mr Dilip Kumar and Mr Ankit Shukla for helping in data management. The activities of the task force were supported by a full and unconditional grant from Dr Reddy's Laboratories, Hyderabad.

Author information

Author notes

  1. Sunil Kumar

    Present address: Assistant Professor, Department of Biotechnology, Shri Ramswaroop Memorial University, Lucknow-Deva Road, Barabanki, (UP)

Authors and Affiliations

  1. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Uday C. Ghoshal, Gourdas Choudhuri & Sunil Kumar

  2. Department of Gastroenterology, P D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, 400 016, India

    Philip Abraham

  3. Department of Gastroenterology, K E M Hospital, Parel, Mumbai, 400 012, India

    Shobna J. Bhatia

  4. Department of Gastroenterology, Moti Lal Nehru Medical College, University of Allahabad, Allahabad, 211 001, India

    Sri Prakash Misra

  5. Department of Gastroenterology, Calcutta Medical College, Kolkata, India

    K. D. Biswas

  6. Department of Gastroenterology, Kothari Medical Centre, 8/3, Alipore Road, Alipore, Kolkata, 700 027, India

    Karmabir Chakravartty

  7. Department of Gastroenterology, S N Medical College, Residency Road, Sector D, Shastri Nagar, Jodhpur, 342 001, India

    Sunil Dadhich

  8. Department of Gastroenterology, Gauhati Medical College, Guwahati, AS 781 034, India

    B. D. Goswami

  9. Department of Gastroenterology, Stanley Medical College, Old Jail Road, Royapuram, Chennai, 600 001, India

    V. Jayanthi

  10. Department of Hepatology, Lakeshore Hospital, Kochi, 682 304, India

    Abraham Koshy

  11. Medical College Hospital, Ulloor Road, Thiruvananthapuram, 695 011, India

    K. R. Vinay Kumar

  12. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Govind Makharia

  13. Department of Gastroenterology, Sawai Man Singh Medical College, J L N Marg, Jaipur, 302 004, India

    Sandeep Nijhawan

  14. Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India

    Nitesh Pratap

  15. Department of Gastroenterology, B R Singh Hospital, Kolkata, 700 014, India

    Gautam Ray

  16. Department of Gastroenterology, G B Pant Hospital, Jawaharlal Nehru Marg, New Delhi, 110 002, India

    Sanjeev Sachdeva

  17. Department of Gastroenterology, S C B Medical College, Cuttack, 753 007, India

    Shivaram Prasad Singh

  18. Department of Gastroenterology, Calicut Medical College, Medical College Road, Calicut, 673 008, India

    Varghese Thomas

  19. Department of Gastroenterology, Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Bhawani Singh Marg, Jaipur, 302 015, India

    Harsh Udawat

Authors
  1. Uday C. Ghoshal
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  2. Philip Abraham
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  20. Varghese Thomas
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Corresponding author

Correspondence to Uday C. Ghoshal.

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Ghoshal, U.C., Abraham, P., Bhatia, S.J. et al. Comparison of Manning, Rome I, II, and III, and Asian diagnostic criteria: Report of the Multicentric Indian Irritable Bowel Syndrome (MIIBS) study. Indian J Gastroenterol 32, 369–375 (2013). https://doi.org/10.1007/s12664-013-0365-7

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  • DOI: https://doi.org/10.1007/s12664-013-0365-7

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