Unifying Concepts

ROME II Diagnostic Criteria for Functional Disorders of the Anus and Rectum

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

F1. Functional Fecal Incontinence

Recurrent uncontrolled passage of fecal material for at least one month, in an individual with a developmental age of at least 4 years, associated with:

  1. Fecal impaction; or
  2. Diarrhea; or
  3. Nonstructural anal sphincter dysfunction.

F2. Functional Anorectal Pain

F2a. Levator Ani Syndrome

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

  1. Chronic or recurrent rectal pain or aching;
  2. Episodes last 20 minutes or longer; and
  3. Other causes of rectal pain such as ischemia, inflammatory bowel disease, cryptitis, intramuscular abscess, fissure, hemorrhoids, prostatitis, and solitary rectal ulcer have been excluded.

F2b. Proctalgia Fugax

  1. Recurrent episodes of pain localized to the anus or lower rectum;
  2. Episodes last from seconds to minutes; and
  3. There is no anorectal pain between episodes.

F3. Pelvic Floor Dyssynergia

  1. The patient must satisfy diagnostic criteria for functional constipation in Diagnostic Criteria C3;
  2. There must be manometric, EMG, or radiologic evidence for inappropriate contraction or failure to relax the pelvic floor muscles during repeated at-tempts to defecate;
  3. There must be evidence of adequate propulsive forces during attempts to defecate, and
  4. There must be evidence of incomplete evacuation.


  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: Mar 19, 2005

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