The diagnosis of a Functional Bowel Disorder always presumes the absence of a structural or biochemical explanation for the symptoms.

C1. Irritable Bowel Syndrome

1. Relieved with defecation; and/or
2. Onset associated with a change in frequency of stool; and/or
3. Onset associated with a change in form (appearance) of stool.

Symptoms that Cumulatively Support the Diagnosis of Irritable Bowel Syndrome

• Abnormal stool frequency (for research purposes “abnormal” may be defined as greater than 3 bowel movements per day and less than 3 bowel movements per week);
• Abnormal stool form (lumpy/hard or loose/watery stool);
• Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation);
• Passage of mucus;
• Bloating or feeling of abdominal distension.

C2. Functional Abdominal Bloating

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. Feeling of abdominal fullness, bloating, or visible distension; and
2. Insufficient criteria for a diagnosis of functional dyspepsia, irritable bowel syndrome, or other functional disorder.

C3. Functional Constipation

At least 12 weeks, which need not be consecutive, in the preceding 12 months of two or more of:

1. Straining >1/4 of defecations;
2. Lumpy or hard stools >1/4 of defecations;
3. Sensation of incomplete evacuation >1/4 of defecations;
4. Sensation of anorectal obstruction/blockage >1/4 of defecations;
5. Manual maneuvers to facilitate >1/4 of defecations (e.g., digital evacuation, support of the pelvic floor); and/or
6. < 3 defecations per week.

Loose stools are not present, and there are insufficient criteria for IBS.

C4. Functional Diarrhea

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. Loose (mushy) or watery stools
2. Present >3/4 of the time; and
3. No abdominal pain.

C5. Unspecified Functional Bowel Disorder

Bowel symptoms in the absence of organic disease that do not fit into the previously defined categories of functional bowel disorders.

References:

1. Douglas A. Drossman. ROME II: The Functional Gastrointestinal Disorders, Second Edition

This material was taken from the ROME II. It is intended for educational purposes only.

Created: March 19, 2005