Calculators & Tools

Rome IV — Non-Retentive Faecal Incontinence

Children with a developmental age ≥ 4 years; ≥1 month duration.

1 What is the Rome IV — Non-Retentive Faecal Incontinence?

The Rome IV — Non-Retentive Faecal Incontinence is a GI & Liver scoring tool used in paediatric practice. Children with a developmental age ≥ 4 years; ≥1 month duration. It scores 3 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 3 criteria: Defaecation into places inappropriate to the sociocultural context; No evidence of faecal retention; Not explained by another medical condition after appropriate evaluation. Totals are then banded: any score - Criteria not met: all three criteria are required. If there IS faecal retention, this is retentive incontinence (functional constipation) instead; 3 criteria or more - Criteria met: rome IV non-retentive faecal incontinence. Manage with toilet-training programmes and behavioural support; laxatives are NOT indicated and may worsen soiling.
  • Distinguishing this from constipation-associated soiling is essential - the treatments differ completely.
  • 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 — Non-Retentive Faecal Incontinence use?

3. They are Defaecation into places inappropriate to the sociocultural context; No evidence of faecal retention; Not explained by another medical condition after appropriate evaluation.

What do the bands of the Rome IV — Non-Retentive Faecal Incontinence mean?

The total is interpreted as: any score - Criteria not met: all three criteria are required. If there IS faecal retention, this is retentive incontinence (functional constipation) instead; 3 criteria or more - Criteria met: rome IV non-retentive faecal incontinence. Manage with toilet-training programmes and behavioural support; laxatives are NOT indicated and may worsen soiling.

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?

Distinguishing this from constipation-associated soiling is essential - the treatments differ completely.

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.