The defect in the Rome IV Criteria for diagnosing IBS-D
The Rome IV Criteria are the official criteria applied by doctors to diagnose functional gastrointestinal disorders. There is a significant defect in the criteria prescribed for the diagnosis of irritable bowel syndrome – diarrhea (IBS-D), which will result in failure to diagnose and treat many patients including me. Worse, this flaw will defeat the effectiveness and reliability of research projects now underway.
The main criterion required by Rome IV to diagnose IBS-D is recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
I suffer occasional heartburn associated with nausea but not abdominal pain. Diarrhea typically occurs two or three days after the heartburn and nausea – they are related symptoms but not concurrent. I do not suffer abdominal pain at the time of diarrhea.
There is no cure for IBS-D. However, University-affiliated gastroenterologists are conducting research to try to identify causes including possible dietary, microbial and genetic causes. These research studies choose their study subjects by applying the Rome IV Criteria. If the subject patients are not properly identified, the research will be flawed and the chance of identifying causes will be reduced. This flaw in the criteria is disheartening to those of us who suffer chronic diarrhea.
The main criterion required by Rome IV to diagnose IBS-D is recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
- Related to defecation
- Associated with a change in frequency of stool
- Associated with a change in form (appearance) of stool
- 25% of bowel movements are watery or soft/mushy pieces with ragged edges (poop categories 6 or 7)
I suffer occasional heartburn associated with nausea but not abdominal pain. Diarrhea typically occurs two or three days after the heartburn and nausea – they are related symptoms but not concurrent. I do not suffer abdominal pain at the time of diarrhea.
There is no cure for IBS-D. However, University-affiliated gastroenterologists are conducting research to try to identify causes including possible dietary, microbial and genetic causes. These research studies choose their study subjects by applying the Rome IV Criteria. If the subject patients are not properly identified, the research will be flawed and the chance of identifying causes will be reduced. This flaw in the criteria is disheartening to those of us who suffer chronic diarrhea.
