Rome IV Diagnostic Criteria for Unspecified Functional Bowel Disorder

Rome IV Unspecified Functional Bowel Disorder

Bowel symptoms present (e.g., pain, bloating, diarrhea, constipation)

Not attributable to an organic etiology

Does NOT meet criteria for IBS

Does NOT meet criteria for functional constipation

Does NOT meet criteria for functional diarrhea

Does NOT meet criteria for functional bloating/distension

Present for last 3 months with onset ≥6 months prior

Rome IV Assessment: Negative

Criteria Not Met

No criteria met for Rome IV unspecified functional bowel disorder.

Official Rome IV criteria for the diagnosis of unspecified functional bowel disorder.

Why Use

Used to diagnose unspecified functional bowel disorder in the absence of secondary causes of bowel symptoms or another functional bowel disorder. Making a diagnosis will help guide the need for further work-up and management. Establishing a diagnosis may be helpful in having a conversation with patients about the role of the gut-brain axis in the development of bowel symptoms.

When to Use

Use in patients who present with bowel symptoms for which there is no systemic cause and where they do not meet criteria for another functional bowel disorder such as irritable bowel syndrome , functional constipation , functional diarrhea , or functional abdominal bloating/distension .

Formula

To fulfill the Rome IV criteria for unspecified functional bowel disorder, patient must have the following (for 3 months prior with symptom onset ≥6 months ago): Bowel symptoms not attributable to an organic etiology that do not meet criteria for IBS or functional constipation , diarrhea , or abdominal bloating/distention disorders.

Pearls / Pitfalls

It is important to ensure the patient does not have another functional bowel disorder prior to establishing this diagnosis. The use of the irritable bowel syndrome , functional constipation , functional diarrhea , or functional abdominal bloating/distension calculators may be helpful. It is important to follow the patient to see their symptoms evolve to meet a more specific criteria for another disorder of gut brain interaction, e.g. IBS.

Management

Management should be guided by patient symptoms and severity. To date, there are no studies to support specific treatment in unspecified functional bowel disorders.

Critical Actions

This calculator should only be used in patients where a secondary cause of bowel (e.g. structural cause, systemic illness, medications) is not suspected based on clinical history, physical exam and initial work-up.

Advice

If diagnosis not met (negative): Symptoms unlikely to be caused by unspecified functional bowel disorder. Consider further assessment as clinically indicated. If meets diagnosis (positive): Likely diagnosis of unspecified functional bowel disorder. Consider initiating treatment.