What are the Rome III criteria that were used as part of Dr. Mohammed's diagnosis? Using the information from Mrs. Clarke's history and physical, determine how Dr. Mohammed made his diagnosis of IBS
What will be an ideal response?
• The American College of Gastroenterology (ACG) uses the Rome III criteria to diagnose IBS. The basis for these criteria, according to the ACG, is that IBS experts have met in Rome for the past 15 years to decide what methods are best used to diagnose IBS.
• Rome III as diagnostic criteria are accurate about 65-100% of the time, according to the ACG.
• The Rome III criteria include:
• Recurrent abdominal pain or discomfort at least 3 months in the last year with two or more of the following:
• Improvement of pain with defecation
• Onset associated with change in frequency of stool
• Onset associated with change in appearance of stool
• Physician has ruled out other inflammatory and GI disorders with similar symptoms
• Other symptoms may include:
• Altered bowel habits or motility (*key symptom)
• Diarrhea
• Constipation
• Mixed—pt. experiences both constipation and diarrhea
• Lower abdominal pain (*key symptom)
• Flatulence
• Gas
• Upper GI symptoms including:
• Reflux
• Chest pain (non-cardiac)
• The physician was able to diagnose Ms. Clarke with IBS because:
- She experiences both bouts of constipation and diarrhea for many years
- She complains of "several accidents", being unable to make it to the restroom on time
- She endures daily abdominal pain
- Lately several episodes of diarrhea daily (may be evident due to dry mucous membranes - dehydration)
- Hyperactive bowel sounds
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