Table 2.

Evolution of IBS diagnosis criteria ¹.

Diagnosis Criteria	Manning Criteria (1978)	Rome Criteria (1992)	Rome II Criteria (1999)	Rome III Criteria (2006)	Rome IV Criteria (2016)
Main diagnosis symptoms	Abdominal pain that is relieved with a bowel movement	Continuous or recurrent symptoms of: abdominal pain, relieved with defecation, and/or disturbed defecation, usually with bloating or feeling of abdominal distension	At least 12 weeks, which need not be consecutive, in the preceding 12 months of abdominal discomfort or pain	* Recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months	* Recurrent abdominal pain on average at least 1 day/week in the last 3 months
Pain and/or defecation associated features	Looser and more frequent stools Sensation of incomplete evacuation Passage of mucus Abdominal distention	Two or more of: Altered stool frequency Altered stool form (hard or loose/watery) Altered stool passage (straining or urgency, feeling of incomplete evacuation) Passage of mucus	At least two of three following features: Relieved with defecation Change in frequency of stool Change in form (appearance) of stool	Two or more of the following: Improvement with defecation Change in the frequency of stool Change in the form (appearance) of stool	Two or more of the following: Related to defecation Change in the frequency of stool Change in the form (appearance) of stool

* These criteria should be fulfilled for the last three months with symptom onset at least six months prior to diagnosis; ¹ Adapted after: Manning et al., 1978 [195]; Saito et al., 2000 [196]; Sperber et al., 2017 [3]; Lacy et al., 2016 [10]; Lacy and Patel, 2017 [197].