Rome II Guidelines-I stand corrected

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Regular Member

Date Joined Jun 2006
Total Posts : 98
   Posted 7/12/2006 1:47 PM (GMT -7)   
 Earlier today I posted a thread about passing mucous without a stool. Someone replied that this is a symptom of IBS based on the Rome II Guidelines (which have been medically established as definitive of  IBS).
 Under the typical listings of IBS (such as ones you find on the internet) you do not find passing of mucous without a stool as a specific symptom. They only say "excessive amounts of mucous." To me there is a difference and the symptom is not clearly defined. It could mean the passing of mucous IN a stool, the passage of mucous ON a stool or the passage of mucous WITHOUT a stool. I guess because I am a hypochondriac I wanted to make sure that the passage of mucous WITHOUT a stool was truly a symptom of IBS since the typically listed symptoms did not specify the meaning of "excess mucous" and I never go by just what others say or by non-professionals.
 I had never heard of the Rome II Guidelines until the reply so I did some research on it. The only articles I could find were very lengthy and spoke more to professionals than laypersons. I could not find the mention of passing watery, mucous filled stools as a symptom in any of the Rome II Guidelines articles that I read. It was in the early hours of the morning and I gave up my search.
 However (blushing) I did just find a simple article that was easily readable. It does say, "the passage of mucous." I take this to mean that it is the passage of mucous WITHOUT a stool since further down the list it specifies, "passing mucus (white material) during a bowel movement." This differentiates the two and satisfies my concerns.
 I know that many, many threads have been posted that list the symptoms of IBS but for those of you, like myself, who have never heard of or read the Rome II Guidelines for IBS here they are. Remember they have been medically established as definitive of IBS so I believe they are accurate and can be fully trusted.
 My thanks to the reply that led me to these Guidelines.

The Rome II Guidelines are the current standard for IBS

The Rome II diagnostic criteria of Irritable Bowel Syndrome always presumes the absence of a structural or biochemical explanation for the symptoms and is made only by a physician.  (My quote:"This is a real issue for me because I firmly believe and wholeheartedly agree that a thorough exam by a doctor should be done to rule out other illnesses that can mimic IBS).

Irritable Bowel Syndrome can be diagnosed based on at least 12 weeks (which need not be consecutive) in the preceding 12 months, of abdominal discomfort or pain that has two out of three of these features:

1. Relieved with defecation; and/or
2. Onset associated with a change in frequency of stool; and/or
3. Onset associated with a change in form (appearance) of stool.

Symptoms that Cumulatively Support the Diagnosis of IBS:
1. Abnormal stool frequency (may be defined as greater than 3 bowel movements per day and less than 3 bowel movements per week);

2. Abnormal stool form (lumpy/hard or loose/watery stool);

3. Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation);

4. Passage of mucus;

5. Bloating or feeling of abdominal distension.

Supportive Symptoms of IBS:
1. Fewer than three bowel movements a week
2. More than three bowel movements a day
3. Hard or lumpy stools
4. Loose (mushy) or watery stools
5. Straining during a bowel movement
6. Urgency (having to rush to have a bowel movement)
7. Feeling of incomplete bowel movement
8. Passing mucus (white material) during a bowel movement
9. Abdominal fullness, bloating, or swelling
 I stand corrected, eyes
I told my psychiatrist that everyone hates me. He said, "That cannot be true. You haven't met everyone yet!"

Veteran Member

Date Joined Jun 2005
Total Posts : 2976
   Posted 7/12/2006 3:29 PM (GMT -7)   
The thing about the Rome Criteria it doesn't list EVERY possible symptom (probably because there are so many), just the most common ones. It never claims to be exhaustive, just a diagnostic aide for doctors. That's the problem some people have with believing that they have IBS; they don't match everything on the list perfectly. But, like clothing bought from a store, it rarely fits anyone perfectly. The Rome Criteria says with IBS you have pain along with stool problems, but some people actually don't have pain. And some people don't feel any better after having a poop than before having it. And some people wake up in the middle of the night needing to go, even though some doctors believe that IBS doesn't cause that. And some people get nauseated and vomit which is usually not listed as a symptom.

So, in the end, anything that can and does go wrong with your digestive tract--when every other possible cause has been ruled out--is a symptom of IBS. People are coming on here with new and odd symptoms all the time.

I have heard they are working on releasing the Rome Criteria III. I think I just read that they had their convention concerning it at the end of last month, so maybe we can soon find out what all they have revised with it. It may be that they change the symptoms listing to include some new symptoms. The Rome Criteria II is itself a revision, so these rules are by no means set in stone. Defining IBS isn't like defining cancer or diabetes simply because it has no known cause or consistant set of symptoms.
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