Rome IV criteria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Rome IV criteria was published in 2016 and is used for the diagnosis of Irritable Bowel Syndrome. In order to establish the diagnosis of Irritable Bowel Syndrome, the patient must have recurrent pain in the abdomen (on an average, ≥1 day per week, in the previous 3 months) with an onset of ≥6 months before diagnosis. Moreover, pain in the abdomen must be associated with at least two of atleast two of the following features: change in stool frequency, change in stool appearance or pain related to defecation. In addition to this, the patient must have none of the following red flag signs which are indicative of other organic diseases.

To establish the diagnosis of Irritable Bowel Syndrome, the patient must have recurrent pain in the abdomen (On an average, ≥1 day per week, in the previous 3 months) with an onset of ≥6 months before diagnosis-

• Pain in the abdomen must be associated with at least two of the following:
  • Change in stool frequency
  • Change in stool appearance or form
  • Pain related to defecation
• In addition to this, the patient must have none of the following warning signs:
  • Unintentional loss of weight
  • Age ≥50 years, without previous colon cancer screening
  • Recent change in bowel habit
  • Hematochezia or melena i.e. evidence of overt gastrointestinal bleeding
  • Nocturnal pain in the abdomen or passage of stools
  • History of inflammatory bowel disease or colorectal cancer in the family
  • Palpable abdominal mass or presence of lymphadenopathy
  • Positive fecal occult blood test
  • Blood testing showing evidence of iron deficiency anemia

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