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Rome Criteria Explorer

Run the Rome Criteria Explorer MicroSim Fullscreen

For learning only

This MicroSim is an educational exercise. It cannot diagnose irritable bowel syndrome or any other condition. Only a clinician, using a full history, an exam, and sometimes tests, can make a diagnosis. If you have symptoms, talk to a doctor.

About This MicroSim

Irritable bowel syndrome (IBS) is diagnosed mainly from a pattern of symptoms, using criteria written by the Rome Foundation, an international group of experts. This MicroSim turns those criteria into a checklist you can experiment with.

You can choose three versions:

  • Rome IV, adults (2016): recurrent belly pain on average at least 1 day a week in the last 3 months, linked to two or more of three features (related to bowel movements, a change in how often stool happens, a change in how stool looks), with symptoms that started at least 6 months ago. Most published IBS research, including the prevalence numbers in Chapter 10, used this version.
  • Rome V, adults (2026, current): recurrent, but not continuous, pain or discomfort on average at least 3 days a month in the last 3 months, with the same three features and the same timing rule.
  • Rome IV, children and teens aged 4 to 18: belly pain at least 4 days a month over at least 2 months, linked to one or more of the three features, when another medical condition can't fully explain the symptoms.

Fictional profiles cover several cases: Sam (from this book), someone with mild pain only 3 days a month, someone with constant pain, someone whose symptoms started recently, and someone with blood in the stool. The Alarm menu adds warning signs, such as blood in the stool or unplanned weight loss, that always call for medical evaluation, whatever the checklist says. On wider screens, a panel at the bottom compares the same profile across all three versions.

The sim simplifies "at least 1 day a week on average" to "about 4 or more days a month."

How to Use

  1. Start with Rome IV, adults and the Sam profile. Check each green mark against the criteria above.
  2. Choose the Dana profile (pain only 3 days a month). Predict whether she meets Rome IV, then switch the version to Rome V. What changed?
  3. Choose the Marcus profile (pain all day, every day). Compare Rome IV and Rome V. Why does Rome V treat constant pain differently?
  4. Choose the Leah profile. Which rule does she miss? Drag Months since start until she meets the criteria.
  5. Choose the Omar profile. He meets the symptom criteria, but read the alarm message. Why isn't the checklist enough?
  6. Make your own profile with the checkboxes and sliders, and find the smallest number of pain days that meets each version.

Learning Objective

Bloom level: Apply. The learner will apply the symptom-based Rome criteria for IBS to fictional symptom profiles, compare how Rome IV (2016), Rome V (2026), and the child and teen criteria classify the same profile, and recognize that alarm features require medical evaluation regardless of the checklist.

Iframe Embed Code

<iframe src="https://aaryavvatts-lab.github.io/gut-brain-textbook/sims/ch10-rome-criteria-explorer/main.html" height="772px" width="100%" scrolling="no"></iframe>

Lesson Plan

Grade level: 9 to 12 (biology, health science, or psychology)

Duration: 20 to 30 minutes

Activity:

  1. Warm-up (3 minutes). Ask: "If every test comes back normal, can a doctor still diagnose a real condition?" Students write a yes or no and one reason.
  2. Explore (8 minutes). In pairs, students run steps 1 to 4 of How to Use and fill in a table: profile, Rome IV result, Rome V result.
  3. Discuss (6 minutes). Why might Rome V classify more people as having IBS than Rome IV? Connect to the 2026 UK survey in Chapter 10, where 59.0% of people with self-reported IBS met Rome IV and 70.0% met Rome V.
  4. Alarm features (5 minutes). Run the Omar profile. Discuss why a positive diagnosis strategy still includes checking for alarm features.
  5. Limits (3 minutes). Read the "What this model leaves out" box in the chapter and the banner at the top of the sim. Why can't a checklist diagnose anyone?

Assessment questions:

  1. List the three bowel-related features in the Rome criteria for IBS.
  2. A 25-year-old has pain 3 days a month for a year, linked to bowel movements and to looser stools. Does she meet Rome IV? Rome V? Explain.
  3. Why do research numbers like "6.1% of US adults" need the phrase "by Rome IV criteria" next to them?
  4. Name two alarm features, and explain why they lead to more evaluation even when the symptom criteria are met.

Chapter 10: IBS and Disorders of Gut-Brain Interaction