Rome III Diagnostic Criteria for Irritable Bowel Syndrome (IBS)

Rome III Criteria for IBS

Recurrent Abdominal Pain/Discomfort

Improvement with Defecation

Onset with Change in Stool Frequency

Onset with Change in Stool Form

IBS Subtype (Predominant Stool Pattern)

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Official Rome III criteria for the diagnosis of irritable bowel syndrome.

Why Use

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

When to Use

Patients being evaluated for possible IBS.

Formula

Recurrent abdominal pain or discomfort, 3 days per month in the last 3 months, associated with two or more of the criteria below: Criteria fulfilled for the last 3 months with symptom onset 6 months prior to diagnosis. Criteria: Improvement with defecation; and/or Onset associated with a change in stool frequency; and/or Onset associated with a change in stool form (appearance).

Pearls / Pitfalls

The Rome III criteria help diagnose irritable bowel syndrome (IBS). Points to keep in mind: There remains no objective reference (i.e. ‘gold’) standard for IBS; the criteria were developed through a literature review and consensus process.

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 III criteria are helpful in classifying patients and for determining potential therapies.