9 Irritable Bowel Syndrome In The Primary Care Setting In Italy: True Prevalence And Correct Diagnosis

Author(s): 
BOZZANI A (1), UBALDI E (1), AMBROSIO G D (1), L CAVAZZUTI L (2) M. NERI M (3), STANGHELLINI V (4)
(1) S.I.M.G.- Italian College of General Practitioners
(2) Glaxo-Wellcome S.p.A., Verona, Italy.
(3) Dept. of Medicine & Aging Sciences, G. D, Annunzio University, Chieti,
(4) Dept. of Internal Medicine and Gastroenterology, University of Bologna
Text: 
Background:
In contrast with the high prevalence of gastrointestinal symptoms and common opinion that the major cause is functional, the true prevalence of IBS is not known, ranging from 2.4% to 22%. Variability is due to both different diagnostic criteria of IBS adopted and different experimental settings of the epidemiological studies.
Aims: 1. to state the prevalence of IBS in the general population in Italy using standardised diagnostic criteria;
2. to evaluate the predictive value of GP diagnostic judgement.
Methods A cross-sectional, population-based study was carried in 3 Italian Regions: Lombardia (north), Marche (centre), Puglia (south). 49 GPs were asked to give a self-administered validated questionnaire on gastrointestinal symptoms to 80 of people in their list, after randomisation. The true prevalence of IBS was assessed using Manning and Rome II criteria, and GP judgement.
Results: Overall 3789 subjects were evaluated, and 3500 useful questionnaires were included in the analysis. Prevalence of IBS was 8.1% following GP judgement, 7.7% by Manning criteria, 5.4% by Rome II criteria. IBS according to Rome II has a prevalence of 5.3%. In northern Italy, 6.6% in central Italy and 4.8% in southern Italy. GP judgement was concordant with Manning criteria in 62% and with Rome ll criteria in 47%.
Conclusion:
The prevalence of 85 in Italy seems to be lower than expected. The most recent diagnostic criteria for IBS (Rome ll) appear to be more restrictive than the traditional ones (Manning) and they are not yet familiar to Italian GPs.
Literature: 
9 IRRITABLE BOWEL SYNDROME IN THE PRIMARY CARE SETTING IN ITALY: TRUE PREVALENCE AND CORRECT DIAGNOSIS