Benefits and Pitfalls of Change From Rome III to Rome IV Criteria for Irritable Bowel Syndrome and Fecal Incontinence

Current Prospects of Rome Criteria for the Diagnosis of Irritable Bowel Syndrome

“…Although the Rome criteria as symptom-based criteria are initially developed to guide researchers, these criteria nowadays are widely used in research, clinical, and prevalence studies (Drossman, 2016). It has also undergone several revisions periodically to make them more clinically useful and relevant (Sperber et al, 2017;Lin and Chang, 2020).…”

“…Despite the minor change in the IBS diagnostic criteria between Rome III and IV, these changes have a considerable influence on the IBS subtyping, prevalence, specificity, sensitivity, and clinical management (Whitehead and Drossman, 2010;Whitehead et al, 2017;Vork et al, 2018). In fact, since the launch of the Rome IV criteria in 2016, several studies evaluated the effect of possible changes on the IBS prevalence and other factors (Vork et al, 2018;Aziz et al, 2018;Wang et al, 2019;Lin and Chang, 2020). Vork et al, (2018) conducted a large cohort study to determine the IBS prevalence using different tools and the differences between Rome IVpositive and Rome IV-negative, the results showed that the Rome IV IBS population is likely to reflect a subgroup of Rome III IBS patients, with more severe gastrointestinal symptomatology, psychological comorbidities, and lower quality of life.…”

Critical appraisal of international guidelines for the management of fecal incontinence in adults: is it possible to define what to do in different clinical scenarios?

“…Moreover, the level of coping strategies varies significantly and should be taken into consideration when deciding on the best approach. As FI can be one of the numerous symptoms of functional bowel disorders [67], treatment should be tailored to the individual patient and aimed at treating the most bothersome symptom.…”

Combining symptoms and biomarkers: The future diagnostic approach for disorders of gut‐brain interaction?

“…Compared to the Rome III classification, the Rome IV emphasis on pain has identified a smaller population, with more severe symptoms as having IBS, while others are now categorized as having other bowel disorders 29 . All criteria changes in the consensus are driven by progress in scientific data and concepts, and it would be inappropriate to avoid implementing such new insights because they would decrease the size of a diagnostic group.…”