Prevalence of rome iv criteria for irritable bowel syndrome and red flag symptoms in visitors of a patient centered informative website

Introduction: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain and changes in stool pattern Based on dominant stool pattern we can subtype into IBS-D (diarrhea), IBS-C (constipation), IBS-M (mixed) or IBS-U (unspecified) Many undiagnosed patients experiencing chronic abdominal complaints do not immediately visit a health care professional but turn to the internet for advice Therefore, we probably underestimate the prevalence of disorders like IBS Furthermore, when these patients do not visit a doctor, red flag symptoms are not noticed, and more serious diseases could be missed Aims & Methods: The aim of this study was to assess the prevalence of Rome IV criteria for IBS and red flag symptoms in a population visiting an IBS patient centered informative website Visitors of the website had the opportunity to participate in a questionnaire combining the Rome IV criteria and red flags (blood in stool, weight loss, start symptoms after 50 years of age, family history of colon cancer, unexplained fever) Afterwards, they received the results of the Rome IV criteria and the presence of red flag symptoms via mail After informed consent the data was extracted, and the prevalence of positive Rome IV criteria and red flag symptoms was calculated Results: 62 visitors completed the questionnaire and 56 visitors (90 3%) gave permission to use the data for research purposes of these 56 visitors, 35 fulfilled the Rome IV criteria (62 5%) Based on stool pattern 11 were IBS-D (31 4%), 7 IBS-C (20 0%), 15 IBS-M (42 9%) and 2 IBS-U (5 7%) of the visitors not fulfilling the Rome IV criteria this was due to (multiple reasons possible): insufficient abdominal pain (40 9%), insufficient changes in stool pattern (40 9%) or symptoms shorter than 6 months (40 9%) 20 visitors had red flags (35 7%): 8 9% had bloody stools, 16 1% unexplained weight loss, 3 6% unexplained fever, 12 5% a positive family history for colon cancer and 5 4% were older than 50 years when symptoms started Patients fulfilling the Rome IV criteria had a higher percentage of red flags compared to Rome IV negative patients (42 9% versus 23 8%) Conclusion: Since the COVID-19 pandemic there has been an increasing interest in telemedicine Based on our research results, we believe digital questionnaires could aid in the screening of patients presenting with abdominal symptoms Since more than a third of our population has at least one red flag symptom we think patient centered website could also help raise awareness and direct patients at risk towards consulting a health care professional Furthermore, by quickly identifying the presence of red flag symptoms we can pinpoint the patients needing more extensive examinations, like an endoscopy, faster