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Rome IV diagnostic criteria for unspecified functional bowel disorder
Diagnosis of exclusion for bowel symptoms not meeting other Rome IV categories.
Rome IV diagnostic criteria for unspecified functional bowel disorder
Bowel symptoms present (e.g. altered bowel habits, gas, bloating) that are not attributable to an organic or structural cause
Does NOT meet Rome IV criteria for irritable bowel syndrome (IBS)
Does NOT meet Rome IV criteria for functional constipation
Does NOT meet Rome IV criteria for functional diarrhoea
Does NOT meet Rome IV criteria for functional abdominal bloating/distension
Symptoms present for the last 3 months, with onset at least 6 months before diagnosis
ResultCriteria not met
Criteria are not fulfilled — either an organic cause has not been excluded, symptoms meet criteria for one of the specific functional bowel disorders, or the duration requirement is not met.
When to use
- Classifying chronic bowel symptoms that do not fit the specific Rome IV functional bowel disorder categories after organic disease has been excluded.
Formula
Diagnosis of exclusion — requires bowel symptoms not due to an organic aetiology, plus failure to meet Rome IV criteria for IBS, functional constipation, functional diarrhoea, and functional bloating/distension, with symptoms for the last 3 months and onset ≥6 months before diagnosis.
Pearls and pitfalls
- Always exclude alarm features (weight loss, GI bleeding, anaemia, family history of colorectal cancer or IBD) before assigning a functional diagnosis.