How are bowel patterns classified by the Rome IV criteria for the diagnosis of irritable bowel (IBS)?

Updated: Dec 11, 2019
  • Author: Jenifer K Lehrer, MD; Chief Editor: BS Anand, MD  more...
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Four bowel patterns may be seen with irritable bowel syndrome, and these remain in the Rome IV classification. [2] These patterns include the following:

  • IBS-D (diarrhea predominant)

  • IBS-C (constipation predominant)

  • IBS-M (mixed diarrhea and constipation)

  • IBS-U (unclassified; the symptoms cannot be categorized into one of the above three subtypes)

The usefulness of these subtypes is debatable. Notably, within 1 year, 75% of patients change subtypes, and 29% switch between constipation-predominant IBS and diarrhea-predominant IBS. The Rome IV criteria differ from the Rome III criteria in basing bowel habit on stool forms solely during days with abnormal bowel movements rather than on the total number of bowel movements. [2]

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