Defining the irritable bowel

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGIDs) encountered in the community, primary care, and specialist clinics. 1–3 It is recognized to have a complex multifactorial pathophysiology, including psychological and cultural factors, previous gut infections, visceral hypersensitivity, increased permeability, and bile acid malabsorption. 4 IBS does not cause mortality but results in an increased healthcare burden and impaired quality of life due to its poor response to standard medical therapy. 5 To date, there are no specific endoscopic/imaging features, or biomarkers, to diagnose the condition. [...]for the purposes of standardization and research, a group of experts have attempted to define IBS according to certain symptom clusters, which have now been internationally accepted as the Rome Foundation diagnostic criteria. Since their initial iteration, the Rome criteria have been updated every 10 years, with the latest Rome IV criteria developed in 2016. F3: Epigastric pain or burning affected by eating, which gets better after bowel movement or passing gas and preceded by a change in the number of bowel movements F7: Upper abdominal pain or discomfort associated with passing less frequent or passing harder stools Cluster 1: