Irritable bowel syndrome and colon cancer: A meta-analysis

Table 4 Irritable bowel syndrome diagnostic criteria (Rome I vs II vs III vs IV)

Feature	Rome I (1990)	Rome II (1999)	Rome III (2006)	Rome IV (2016)
Core symptom	Abdominal pain relieved with defecation or associated with stool change	Abdominal pain or discomfort	Recurrent abdominal pain or discomfort	Recurrent abdominal pain only (discomfort removed)
Minimum duration	≥ 3 months	≥ 12 weeks in past 12 months	≥ 3 days/month in last 3 months	≥ 1 day/week in last 3 months
Symptom onset before diagnosis	Not clearly defined	Not clearly defined	≥ 6 months before diagnosis	≥ 6 months before diagnosis
Required associated features (≥ 2)	Relief with defecation	Relief with defecation	Related to defecation	Related to defecation
	Change in stool frequency	Change in stool frequency	Change in stool frequency	Change in stool frequency
	Change in stool form	Change in stool form	Change in stool form	Change in stool form
Discomfort allowed?	Yes	Yes	Yes	No
Subtypes defined	Not standardized	Emerging stool-based	IBS-constipation, IBS-diarrhea, IBS-mixed, IBS-U (Bristol scale)	Same subtypes, stricter stool frequency thresholds
Diagnostic strictness	Least strict	More structured	Moderate	Most strict

IBS: Irritable bowel syndrome.