MDCalc

Rome IV Diagnostic Criteria for Unspecified Functional Bowel Disorder

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

Use in patients who present with bowel symptoms for at least 6 months for which there is no systemic cause or other functional bowel disorder.

Patients with any of the following features must be evaluated clinically for other diagnoses even though functional constipation may be present:

  • Signs or symptoms of gastrointestinal bleeding.

  • Unexplained iron deficiency anemia.

  • Unintentional weight loss.

  • Palpable abdominal mass or lymphadenopathy on exam.

  • Family history of colon cancer and have not had age-appropriate colon cancer screening.

  • Onset of symptoms age ≥50 years and have not had age-appropriate colon cancer screening.

  • Sudden or acute onset of new change in bowel habit.

Must have the following:

For 3 months prior with symptom onset ≥6 months ago

Diagnostic Result

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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.

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.