Calculators & Tools

Rome IV — Irritable Bowel Syndrome

Children/adolescents: criteria fulfilled ≥2 months before diagnosis.

1 What is the Rome IV — Irritable Bowel Syndrome?

The Rome IV — Irritable Bowel Syndrome is a GI & Liver scoring tool used in paediatric practice. Children/adolescents: criteria fulfilled ≥2 months before diagnosis. It scores 5 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in GI & Liver
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 5 criteria: Abdominal pain at least 4 days per month; Pain related to defaecation; Change in frequency of stool; Change in form (appearance) of stool; In children with constipation, the pain does not resolve when the constipation resolves. Totals are then banded: any score - Criteria not met: abdominal pain ≥4 days/month plus at least one associated feature is required; 3 criteria or more - Criteria met: rome IV IBS criteria met - abdominal pain ≥4 days/month associated with defaecation and/or a change in stool frequency or form, for ≥2 months. Specify subtype (IBS-C, IBS-D, IBS-M) using the Bristol stool scale.
  • Diagnosis requires that symptoms cannot be fully explained by another medical condition after appropriate evaluation.
  • Source: Hyams JS et al. Rome IV - Functional disorders: children and adolescents. Gastroenterology 2016;150:1456-68.

4 Frequently asked questions

How many criteria does the Rome IV — Irritable Bowel Syndrome use?

5. They are Abdominal pain at least 4 days per month; Pain related to defaecation; Change in frequency of stool; Change in form (appearance) of stool; In children with constipation, the pain does not resolve when the constipation resolves.

What do the bands of the Rome IV — Irritable Bowel Syndrome mean?

The total is interpreted as: any score - Criteria not met: abdominal pain ≥4 days/month plus at least one associated feature is required; 3 criteria or more - Criteria met: rome IV IBS criteria met - abdominal pain ≥4 days/month associated with defaecation and/or a change in stool frequency or form, for ≥2 months. Specify subtype (IBS-C, IBS-D, IBS-M) using the Bristol stool scale.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Diagnosis requires that symptoms cannot be fully explained by another medical condition after appropriate evaluation.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.