The Rome Criteria
The Rome Foundation
The Rome foundation (www.romecriteria.org) is a non-profit organization devoted to the promotion and research of functional gastrointestinal diorders (FGID). Young scientists can obtain funding from this organization to study gastrointestinal disorders. Part of their mission statement is to organize and standardize our understanding of chronic constipation.
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As part of this attempt, the Rome foundation has created several standardized checklists or tests which physicians can use to diagnose gastrointestinal problems.
Functional Diseases: Difficult to Diagnose
The reason for the development of these diagnostic criteria is that oftentimes there is no detectable physical reason for symptoms experienced by patients. In other words, no laboratory diagnostic, imaging or examination reveals abnormalities in the organ structure or biochemistry. As such, it becomes difficult to pin down a definitive diagnosis. The consensus effort of the Rome Foundation is an attempt to bring order to diagnosis of what is purely a functional disease, i.e. chronic constipation manifesting as an impairment in function but otherwise shows no physical defects.
A Set of Guidelines
For example, sometimes patients will have difficult-to-diagnose disorders like chronic nausea with no apparent cause (this is also known as an idiopathic disorder). The Rome foundation has published a short set of guidelines for diagnosing this type of nausea. In the same vein, disorders like irritable bowel syndrome (IBS) and dyspepsia are covered by the same handbook. One of these is chronic constipation. Patients or physicians should refer to it as a useful tool to understand their and their patients' conditions.
The Criteria for Positive Diagnosis of Chronic Constipation
In brief, the Rome criteria for chronic constipation is the following: Must include two or more of the following: 1. a. Straining during at least 25% of defecations b. Lumpy or hard stools in at least 25% of defecations c. Sensation of incomplete evacuation for at least 25% of defecations d. Sensation of anorectal obstruction/blockage for at least 25% of defecations e. Manual maneuvers to facilitate at least 25% of defecations (e.g., evacuation, support of the pelvic floor) f. Fewer than three defecations per week 2. Loose stools are rarely present without the use of laxatives 3. Insufficient criteria for irritable bowel syndrome * Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
There are no guidelines for constipation treatment, which is another domain different from the diagnosis of chronic constipation.
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