Rome II Diagnostic Criteria for Irritable Bowel Syndrome (IBS)

Rome II IBS Criteria Calculator
Abdominal pain or discomfort for ≥12 weeks (not necessarily consecutive) in the preceding 12 months
Relieved with defecation
Onset associated with a change in frequency of stool
Onset associated with a change in form (appearance) of stool
Supporting Features: 0
Official Rome II criteria for the diagnosis of irritable bowel syndrome.

Why Use

The symptoms that define IBS are generally subjective and self-reported, making a classification system helpful. Moreover, there is some evidence to support the notion that patients who meet formal Rome criteria are more likely to respond to some therapies.

When to Use

Patients being evaluated for possible IBS.

Formula

Patient must have at least 12 weeks of abdominal discomfort or pain, which need not be consecutive, in the preceding 12 months with at least 2 of following 3 features: Relieved with defecation. Onset associated with a change in stool frequency. Onset associated with a change in stool form (appearance).

Pearls / Pitfalls

The Rome II Criteria, developed through a literature review and consensus process, defined the diagnosis of Irritable Bowel Syndrome (IBS) until the Rome III and subsequently Rome IV Criteria refined them. There remains no objective reference (i.e., ‘gold standard’) for the diagnosis.

Management

We are unaware of validated management algorithms using the Rome Criteria.

Critical Actions

IBS is a ‘rule-out’ diagnosis, which is to say all other possibilities must be ruled out first.

Advice

The Rome Criteria are helpful in classifying patients and for determining potential therapies.

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