The Rome Diagnostic Criteria for IBS
How is IBS Diagnosed?
While cruising around the web for more information about IBS, I found some interesting history and a very concise definition for IBS. The research organization that came up with the generally accepted diagnostic criteria for IBS is known as the Rome Foundation. They are an independent not for profit organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of functional gastrointestinal disorders. Their mission is to improve the lives of people with functional GI disorders.[i]
At the 13th International Congress of Gastroenterology in Rome, Italy in 1988 a group of physicians defined criteria to more accurately diagnose IBS. Known as the “Rome Criteria,” this set of guidelines make possible a more accurate diagnosis of IBS.
The Rome criteria are:
- 3 months of continuous or recurring symptoms of abdominal pain or irritation that:
- May be relieved with a bowel movement,
- May be coupled with a change in frequency, or
- May be related to a change in the consistency of stools.
- Two or more of the following are present at least 25 percent (one quarter) of the time:
- A change in stool frequency (more than 3 bowel movement per day or fewer than 3 bowel movements per week)
- Noticeable difference in stool form (hard, loose and watery stools or poorly formed stools)
- Passage of mucous in stools
- Bloating or feeling of abdominal distention
- Altered stool passage (e.g. sensations of incomplete evacuation, straining, or urgency)
Symptoms in the Rome Criteria are not the only indicators of IBS. Additional intestinal symptoms may include:
- Nausea (with or without vomiting)
- Full sensation after even a small meal
The Rome Criteria were not widely accepted when originally presented, but were better received after their first revision. This second version, created in 1992 and known as Rome II, added a length of time for symptoms to be present and pain as an indicator. The second revision, known as Rome III, is currently underway.[ii]
It is important to note that the ONLY way to be absolutely certain you have IBS is through a doctor’s diagnosis. A diagnosis of IBS is only made once other diseases that have similar symptoms are ruled out. This is known as a diagnosis of exclusion. There is no specific test for IBS. Instead, your doctor will do other tests to rule out things like parasites, Crohn’s, ulcerative colitis, and bowel cancer. Once these are ruled out, and if you are still having symptoms that fit the Rome criteria (above), then your doctor may give you the diagnosis of IBS.
Unfortunately, some doctors don’t consider IBS a “true” disease, probably because it is not diagnosed by a definitive test, but by excluding everything else that it could be based on your symptoms. I had one physician tell me that IBS is not a “diagnosis” but just a name for a group of symptoms. While that is technically true based on the way it is diagnosed, I find that doctors who think this way consider IBS to be an unimportant minor condition (when in reality we know that it isn’t very “minor” to those of us who have to deal with it). If you get this kind of brush off from a doctor, you should seek a second opinion. There ARE competent doctors out there who are very good at dealing with IBS cases.
[i] http://www.romecriteria.org/about/ (accessed July 23, 2014)
[ii] http://ibdcrohns.about.com/cs/ibs/a/romecriteria.htm (accessed July 23, 2014)