What Is the Rome IV Criteria for Diagnosis of Irritable Bowel Syndrome IBS )?

By Alice Nichols

The Rome IV criteria is a set of guidelines used for the diagnosis of irritable bowel syndrome (IBS). It was developed by an international group of experts in the field of gastroenterology. These criteria help healthcare professionals identify and classify IBS based on specific symptoms and criteria.

What is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is a chronic disorder that affects the large intestine. It is characterized by recurring abdominal pain, bloating, and changes in bowel habits, such as diarrhea or constipation. IBS is a functional disorder, meaning that it does not cause any structural damage to the intestines.

The Rome IV Criteria

The Rome IV criteria:

  • Recurrent abdominal pain: This pain should be present on average at least 1 day per week in the last 3 months or associated with changes in stool frequency or form.
  • Criteria for pain relief: The pain should be related to defecation (passing stool) or associated with a change in stool frequency or form.
  • Change in bowel habits: There should be evidence of either increased frequency of bowel movements or a change in the appearance or consistency of stools.
  • Additional symptoms: The presence of bloating, urgency (sudden urge to have a bowel movement), and/or incomplete evacuation (feeling like there’s more stool to pass) can support the diagnosis.

Subtypes of IBS

The Rome IV criteria also classify IBS into different subtypes based on stool consistency:

  • IBS with constipation (IBS-C): This subtype is characterized by hard or lumpy stools at least 25% of the time and loose or watery stools less than 25% of the time.
  • IBS with diarrhea (IBS-D): This subtype is characterized by loose or watery stools at least 25% of the time and hard or lumpy stools less than 25% of the time.
  • Mixed IBS (IBS-M): This subtype is characterized by both loose or watery stools and hard or lumpy stools at least 25% of the time.
  • Unsubtyped IBS (IBS-U): This subtype is diagnosed when a person does not meet the criteria for any specific subtype, but still experiences symptoms consistent with IBS.

Diagnosing IBS Using Rome IV Criteria

In order to diagnose IBS using the Rome IV criteria, a healthcare professional must consider several factors:

  • The presence and frequency of abdominal pain or discomfort for at least three days per month in the last three months.
  • The duration of symptoms, which should be ongoing for at least six months.
  • The absence of certain warning signs that may indicate other gastrointestinal conditions, such as unexplained weight loss, blood in stool, fever, or family history of certain conditions like colon cancer.

If a person meets all necessary criteria outlined by the Rome IV guidelines, a diagnosis of IBS can be made. However, it’s important to note that there are no specific tests to definitively diagnose IBS. The diagnosis is primarily based on symptom assessment and exclusion of other potential gastrointestinal disorders.

Conclusion

The Rome IV criteria provide a standardized approach for the diagnosis of irritable bowel syndrome (IBS). By following these criteria, healthcare professionals can accurately identify and classify IBS subtypes based on specific symptoms and criteria. If you suspect that you may have IBS, it is important to consult with a healthcare professional for proper evaluation and diagnosis.