Figure 3.

Changes in diagnostic criteria for irritable bowel syndrome (IBS) from Rome III to Rome IV. In Rome IV abdominal ‘discomfort’ has been deleted from the definition because of the imprecise nature of the term together with the fact that ‘discomfort’ is not present in every language; abdominal pain should be present at least 1 day a week on average during the preceding 3 months; ‘Improvement with’ defecation has been changed to ‘Related to’ defecation as in a subgroup of patients it may increase or remain without changes; and ‘Onset’ has been deleted from the associated changes in frequency and change in form (appearance) of stools. Adapted from Longstreth GF et al⁵³ and Mearin F et al.⁴⁹