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    Chief Complaint


    Organ System


    Patent Pending

    Rome IV Diagnostic Criteria for Irritable Bowel Syndrome (IBS)

    Provides criteria for diagnosis of irritable bowel syndrome.


    Use in patients with recurrent abdominal pain at least 1 day per week in the last 3 months on average, associated with ≥2 of the criteria below. The criteria are fulfilled with symptoms onset 6 months prior to diagnosis.

    When to Use

    Patients being evaluated for possible IBS.

    How Rome IV has changed from Rome III:

    • Intended to be applied to a more multicultural population than Rome III, which was derived for a Western cohort.
    • Requires only pain as a symptom (“discomfort” has been eliminated because it is nonspecific). Pain can either increase or decrease with bowel movements, versus decreasing only in Rome III.
    • Includes criteria for subtypes of IBS.

    Point 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.
    Must have ≥2 of the following:

    Associated with recurrent abdominal pain ≥1 day/wk in the last 3 months (on average)

    Diagnostic Result:

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    Next Steps
    Creator Insights


    Differences between Rome III and Rome IV:

    Differences between Rome IV and Rome III Criteria for IBS

    Drossman 2017.


    About the Creator
    Dr. Douglas Drossman
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