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Home » Getting Diagnosed

What is the Rome IV criteria?

Michelle, aka the irritable vegan, is a middle-aged white woman identifying as she/her. She is standing in front of a wood pallet wall, making eye contact with the camera. She is smiling over the top of a pumpkin shaped mug of mocha hot chocolate.
Modified: Apr 3, 2025 · Published: Apr 7, 2021 by Michelle @ The Irritable Vegan · This post may contain affiliate links · Leave a Comment

The Rome IV criteria is used Internationally by the medical profession to maintain consistency when diagnosing IBS. The criteria is a set of guidelines based on the typical symptoms and frequency shared by the majority of IBS sufferers.

A diagnosis of IBS will be considered if you meet the following criteria:

Recurrent abdominal pain on average at least 1 day a week in the last 3 months, associated with two or more of the following criteria:

1. Related to defecation

2. Associated with a change in the frequency of stool

3. Associated with a change in the form (appearance) of stool

(These criteria should be fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.)

In addition to the Rome IV criteria your doctor will also check if you are experiencing at least two of these four additional symptoms:

  1. Altered stool passage (straining, urgency, incomplete evacuation)
  2. Abdominal bloating (more common in women than men), distension, tension or hardness
  3. Symptoms made worse by eating
  4. Passage of mucus.

[1]

Other common symptoms of IBS such as lethargy, nausea, backache and bladder issues may help your doctor to support a diagnosis of IBS.

Your doctor will also need to know about any other signs and symptoms that may suggest you have a condition other than IBS. These are known as "red flag" symptoms.

Do you suspect you may have IBS? Could you do with some support as you navigate your tests, doctors appointments and diagnosis? We break it all down into easy to manage steps in these posts.

Have you heard of the Rome IV criteria before?

More Getting Diagnosed with IBS

  • What is IBS clickable link.
    What is IBS?
  • What causes IBS clickable link.
    What causes IBS?
  • I think I have IBS clickable link.
    I think I have IBS
  • What are red flag symptoms clickable link.
    What are red flag symptoms?

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Please be aware that these resources are for your information only. They do not replace the experience of a qualified dietitian. The Irritable Vegan is not a medical professional. As a fellow IBS sufferer, she presents biased opinions based on her experiences. We aim to simplify freely available research and information as a starting point for your unique journey. You should seek a clinical diagnosis of IBS and consult your healthcare team for personalised advice specific to your condition. Please do this before changing your diet, lifestyle or medication. The low FODMAP diet is not intended for weight loss or calorie restriction. It is a clinically approved diet for the treatment of IBS in medically diagnosed sufferers, where other first-line treatments have proved ineffective. You are not advised to undertake a low FODMAP diet without direct supervision from a FODMAP-trained dietitian. The restrictive phase of the low FODMAP diet should generally only be followed for a maximum of 6 weeks. Your personal timeframe for completing the diet will need to be tailored to meet your medical and nutritional needs. A FODMAP-trained dietitian should assess and monitor this to avoid the risk of nutritional deficiencies and disordered eating. The Irritable Vegan accepts no liabilities for any loss or damage resulting from the use of this website or information contained herein. Access to and use of this website and its information is at the risk of the user.