Irritable Bowel Syndrome
International diagnostic criteria, Rome IV, released May 2016

Recurrent abdominal pain at least 1 day/week in the last
3 months associated with two or more of the following:
1. Related to defecation
2. change in frequency of stool
3. change in form (appearance) of stool
* Criteria fulfilled for the last 3 months with symptom onset
at least 6 months prior to diagnosis

The Rome Foundation is an independent not for profit 501(c) 3 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 (FGIDs). Our mission is to improve the lives of people with functional GI disorders.

Over the last 19 years, the Rome organization has sought to legitimize and update our knowledge of the FGIDs. This has been accomplished by bringing together scientists and clinicians from around the world to classify and critically appraise the science of gastrointestinal function and dysfunction. This knowledge permits clinical scientists to make recommendations for diagnosis and treatment that can be applied in research and clinical practice.

The Rome Foundation is committed to the continuous development, legitimization and preservation of the field of FGIDs through science-based activities. We are inclusive and collaborative, patient-centered, innovative and open to new ideas.  (From the Rome Foundation website. Quoted with permission)

Rome Foundation Website and Resources

International functional GI experts finalized Rome IV, the first major update to the Rome criteria since 2006, in December 2014 in Rome, Italy. Rome IV was published in the journal Gastroenterology in May 2016 and officially presented to the gastroenterology professional community at the Digestive Disease Week conference in San Diego, California, USA on May 21-25, 2016.

by Douglas A. Drossman, MD, MACG of the Drossman Center for the Education and Practice of Biopsychosocial Care, the University of North Carolina and the Rome Foundation. Gastroenterology, May 2016.

Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice.

by Magnus Simren, MD, University of Gothenburg,  Gothenburg, Sweden, Olafur S. Palsson, PsyD and William E. Whitehead, PhD, both from the Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, NC, USA.  Current Gastroenterology Reports, April 2017

From the IBS Impact blog:

New Rome IV Diagnostic Criteria for Irritable Bowel Syndrome Unveiled May 2016 (June 9, 2016)

New Rome IV Diagnostic Criteria for Irritable Bowel Syndrome Will Include Individualized Clinical Profiles,  (October 11, 2015)

“Behind the Scenes at Rome IV Foundation” Video Humanizes Functional GI Experts, (February 23, 2015)


Other important information on the nature of IBS, symptoms, diagnosis and standards of medical care can be found below.

IBS Impact blog post Irritable Bowel Syndrome (IBS) Is Not a Diagnosis of Exclusion

IBS Impact blog post An Evolving Redefinition of Severity in Irritable Bowel Syndrome (IBS)

IBS Impact blog post 15 Common Misconceptions That Shouldn’t Exist About Irritable Bowel Syndrome (IBS)

IBS Impact blog post Irritable Bowel Syndrome (IBS) and the Myth of a Cure

IFFGD International Foundation for Functional Gastrointestinal Disorders
IBS Symptoms

National professional organization guidelines for the diagnosis and/or treatment of IBS

In the United States:  American College of Gastroenterology – August 2014

American Gastroenterological Association— November 2014

In the United Kingdom: National Institute for Health and Clinical Excellence–February 2015

British Society of Gastroenterology -2007

British Dietetic Association- 2010, Reviewed 2013,

 BDA Updated 2016

In Australia: Gastroenterological Society of Australia (GESA) 2006

In New Zealand: Best Practices Advocacy Centre, New Zealand (BPACnz, private non-profit organization)-2014

IBS – Beyond the Bowel: The Meaning of Co-existing Medical Problems
Olafur S. Palsson, Psy.D. and William E. Whitehead, Ph.D.
UNC Center for Functional GI & Motility Disorders

UNC-CH Functional Gastrointestinal Disorders Center (lots of good information on a variety of issues)
Educational GI Handouts

What are FGIDs?

Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality  (original article 2009, updated 2017)

Brennan M.R. Spiegel, MD, MSHS

2007 IFFGD Research Award Recipient

then at VA Greater Los Angeles Health System and David Geffen School of Medicine, UCLA, now at Cedars-Sinai Health System and UCLA

The article states that Rome international diagnostic criteria for IBS, based on symptoms, are considered to be 98% accurate. Extensive testing of all people with potential IBS is unnecessary and discouraged, and is usually appropriate only for a few subgroups at higher risk of different GI disorders. Unfortunately studies show that health care providers in local communities are much more likely than IBS/functional GI specialists to still believe erroneously that IBS is a diagnosis of exclusion requiring many tests to rule out other conditions.


Last update to IBS page: June 2017