{"id":4063,"date":"2016-06-30T18:08:30","date_gmt":"2016-06-30T22:08:30","guid":{"rendered":"https:\/\/www.med.unc.edu\/medicine\/unc-researchers-help-create-key-diagnostic-measures-for-gastrointestinal-disorders\/"},"modified":"2023-06-06T17:16:26","modified_gmt":"2023-06-06T21:16:26","slug":"unc-researchers-help-create-key-diagnostic-measures-for-gastrointestinal-disorders","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/medicine\/news\/unc-researchers-help-create-key-diagnostic-measures-for-gastrointestinal-disorders\/","title":{"rendered":"UNC researchers help create key diagnostic measures for gastrointestinal disorders"},"content":{"rendered":"

UNC School of Medicine faculty members took on critical roles in amending diagnostic criteria questionnaires for functional GI disorders, which affect millions of people worldwide.<\/p>\n

\n
\"image2\"
Miranda van Tilburg, PhD<\/figcaption><\/figure>\n
\"image3\"
William E. Whitehead, PhD<\/figcaption><\/figure>\n<\/div>\n
\n

Media contact: Caroline Curran, (984) 974-1146,caroline.curran@unchealth.unc.edu<\/a><\/p>\n

CHAPEL HILL, NC \u2014 With no laboratory test available to diagnose functional gastrointestinal disorders, proper diagnostic criteria are critical for clinicians to make an accurate determination of what ails their patients.<\/p>\n

Several University of North Carolina School of Medicine researchers played a key role in crafting diagnostic criteria and patient questionnaires for theRome Foundation<\/a>, an international nonprofit aimed at improving the lives of the millions of people suffering from functional GI disorders (FGIDs), while developing and legitimizing the field of FGIDs through science and research.<\/p>\n

William E. Whitehead<\/a>, PhD, professor of medicine in the division of gastroenterology and hepatology and director of the UNC Center for Functional GI and Motility Disorders has served on the Rome Foundation Board since its inception.<\/p>\n

Functional GI disorders don\u2019t have a clear, organic cause, and cannot be caught on any lab test, Whitehead said.<\/p>\n

If a person has a functional GI disorder, \u201cthe gut is healthy, but it functions differently,\u201d said Miranda van Tilburg, PhD, an associate professor of medicine in the division of gastroenterology and hepatology, who contributed to the new diagnostic criteria. \u201cWe have to [diagnosis] based on symptoms\u2026You could compare it to a [mental health diagnosis] in a way. For example, you cannot do a blood test for depression. You have to ask people questions and so we have to do the same thing for these disorders.\u201d<\/p>\n

As researchers have learned more about these disorders, it has been necessary to update the diagnostic tools available to clinicians.<\/p>\n

\u201cThe diagnostic criteria for functional GI and some motility disorders have gone through four editions, so the one that\u2019s just been released \u2013 Rome IV \u2013 is being published about 10 years after Rome III. It tries to incorporate the research that\u2019s been done since that time,\u201d Whitehead said.<\/p>\n

Whitehead, along with van Tilburg, Douglas Drossman, MD<\/a>, and Olafur Palsson<\/a>, PsyD, played a critical role in the amended diagnostic criteria and patient questionnaires published in Rome IV. Drossman, who currently serves as president of the Rome Foundation, is an emeritus co-director of the UNC Center for Functional GI and Motility Disorders and adjunct professor of medicine and psychiatry. Palsson is a professor of medicine in the division of gastroenterology and hepatology and a member of the UNC Center for Functional GI and Motility Disorders.<\/p>\n

\u201cOur job was, in part, to develop a diagnostic questionnaire based on criteria that committees of experts developed for making these diagnoses,\u201d Whitehead said. \u201cDeveloping these materials was a multi-year process to be sure it was understandable and translatable to other languages and that it was valid in the sense that it agrees with the diagnoses of expert clinicians.\u201d<\/p>\n

\u201cThis year, there was a lot of time spent on the adult questionnaire,\u201d van Tilburg said \u2013\u201crevamping the answer categories so that they were more sensitive and better able to catch the symptoms we needed to catch.\u201d<\/p>\n

A commonly diagnosed disorder that underwent diagnostic changes is Irritable Bowel Syndrome (IBS), which affects an estimated six percent of the population \u2013 or about 19 million people in the United States. Before the new diagnostic criteria, an estimated 11 percent of the population was thought to have IBS or at least presented symptoms that mirrored IBS, Whitehead said.<\/p>\n

\u201cIn the adult criteria, [IBS] used to be diagnosed based on the presence of abdominal pain or discomfort at least three times a month,\u201d Whitehead said. \u201cThe new criteria require that there be pain \u2013 so discomfort doesn\u2019t qualify \u2013 and it requires that it occur at least once a week on average. There are also some changes in the way that sub-types of IBS are diagnosed, which often dictate what treatment is appropriate \u2013 what drugs, especially.\u201d<\/p>\n

On the pediatric front, there are new categories of disorders that weren\u2019t previously included at all that are now recognized, such as functional nausea and functional vomiting, van Tilburg said. New adult diagnoses included cannabinoid-induced nausea and opiate-induced constipation.<\/p>\n

Van Tilburg also played an important role in revising the child\/adolescent diagnostic criteria. She was on a committee of six worldwide experts tasked to revise these criteria. Because of the new criteria, between Rome III and Rome IV, the prevalence of IBS in children\/adolescents has increased from 2.8 percent to 5 percent. Prevalence of any functional GI disorder increased only slightly; these disorders affect nearly one in four children.<\/p>\n

Rome IV can be ordered here.<\/a> Learn more about the research done at the UNC Center for Functional GI and Motility Disorders here<\/a>.<\/i><\/p>\n

The Rome Foundation was founded in 1988, when a committee of GI physicians was convened to develop diagnostic criteria for irritable bowel syndrome (IBS). From that meeting, the Rome publication was borne. The foundation recently published its fourth version of its medical publication, Rome IV.<\/i><\/p>\n

\u00a0<\/i><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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