Prevalence and clinical characteristics of irritable bowel syndrome in Taiwan: Rome III versus Rome IV criteria

BACKGROUND: No population-based study has examined the updated prevalence of irritable bowel syndrome (IBS) based on the more stringent Rome IV criteria in Taiwan. We aimed to investigate the prevalence and clinical characteristics of IBS using both Rome III and Rome IV criteria in a Taiwanese population and to evaluate the applicability of Rome IV criteria. METHODS: We conducted a prospective study of adults attending periodic health check-ups at our institution. IBS was diagnosed according to both the Rome III and IV criteria. Collected data included demographics, anthropometric measurements, upper endoscopy and colonoscopy, Athens Insomnia Scale and Brief Symptom Rating Scale for mental health evaluation. RESULTS: Among 2688 participants, the prevalence of IBS was 6.4% (n = 172) using Rome III criteria and .5% (n = 14) using Rome IV criteria, with only 8.1% of Rome III cases meeting Rome IV criteria. The Rome IV group was younger than the Rome III-only IBS group (38.5 vs 52.0 years; P = .006), but other characteristics were similar. Multivariable analysis identified factors associated with Rome III-defined IBS, including psychological symptoms (adjusted odds ratio [aOR], ranging from 1.63 to 5.18, all P < .05), insomnia (aOR, 1.74; 95% confidence interval [CI], 1.21-2.48), and late evening eating (aOR, 1.95; 95%CI, 1.36-2.78). CONCLUSION: The prevalence of IBS diagnosed using the Rome IV criteria was substantially lower than that based on the Rome III criteria in the Taiwanese population, which suggests that the Rome IV criteria may not fully capture the spectrum of IBS in Asian populations and further refinements are needed.