Irritable bowel syndrome and the Rome III criteria: for better or for worse?

This is an early evaluation of the Rome III criteria against the Rome II criteria for IBS. Rigid application of the symptom frequency and duration requirements of the Rome II criteria could have introduced a selection bias for patients with greater psychological disturbance. Rome III criteria may better reflect the average IBS patient we see in our clinics. IBS and other functional bowel disorders could be part of a spectrum of similar bowel disturbances rather than distinct entities. More attention to and interest in the average patient as opposed to the chronically severe patient, may translate into better outcomes in terms of reduction in specialist referral, unnecessary surgery and potentially harmful alternative treatments.