Manning criteria 7 |
(1) Abdominal pain relieved by defecation |
(2) Looser stools with onset of pain |
(3) More frequent stools with onset of pain |
(4) Abdominal distension |
(5) Passage of mucus in stools |
(6) Sensation of incomplete evacuation |
Factor analysis shows the first three symptoms correlate well but are not related to (4), (5) and (6).8 |
Rome I criteria 9 |
At least three months of recurrent symptoms of: |
(1) Abdominal pain or discomfort relieved with defecation, or associated with a change in stool frequency, or associated with a change in stool consistency and |
(2) Two or more of the following on at least 25% of occasions or days: |
Altered stool frequency |
Altered stool form |
Altered stool passage |
Passage of mucus |
Bloating or distension |
It should be recognised that these criteria were drawn up with the support of the pharmaceutical industry to allow greater comparability between studies of drug effects. They are a consensus and should not become a straitjacket to prevent scientific enquiry. Many patients with abdominal pain and disturbed bowel habit do not exactly fit these criteria, yet their clinical course is similar. The Rome criteria have recently been revised as follows. |
Rome II criteria 10 |
12 weeks or more in the last 12 months of abdominal discomfort or pain that has two of the following three features: |
(1) Relieved by defecation |
(2) Associated with a change in frequency of stool |
(3) Associated with a change in consistency of stool |
The second group of criteria included in Rome I are now considered supportive rather than mandatory in the diagnosis. |