Rome IV criteria · self-test

Which IBS subtype
does your pattern fit?

The Rome IV criteria classify Irritable Bowel Syndrome into four subtypes, IBS-C, IBS-D, IBS-M, and IBS-U, based on the percentage of stools that fall into the abnormal-form bands. This classifier applies the criteria to your stool-type log and returns the matching subtype with a confidence indicator based on log length.

rome iv ibs subtype self-test

Important. This classifier applies the Rome IV symptom criteria to your stool-type log. It does not diagnose IBS, that requires a clinician to rule out organic causes. Use this tool after a doctor has indicated IBS as a working diagnosis, to clarify which subtype fits your pattern best.

your bristol stool log

Log period (days)

Enter how many stool entries fell into each band over your 14-day log. Total across all bands should equal the number of stools you logged.

Types 1-2 (separate hard lumps / sausage but lumpy)

4

Types 3-4 (cracked sausage / smooth soft sausage)

2

Type 5 (soft blobs with clear edges)

2

Types 6-7 (mushy/fluffy / liquid)

6

Total: 14 entries

rome iv thresholds

Types 1-2 above 25% = constipation-predominant signal. Types 6-7 above 25% = diarrhoea-predominant signal. Both above 25% = mixed. Both below 25% = unsubtyped.

classification

IBS-M (Mixed)

Mixed pattern. Both type 1-2 stools AND type 6-7 stools each exceed 25% of total. Day-to-day variability is high.

Confidence: 100% (based on 14 entries; 14+ entries gives higher confidence)

distribution

Types 1-229% · above 25% threshold
Types 3-529%
Types 6-743% · above 25% threshold

Source: Rome Foundation, Rome IV Diagnostic Criteria for Disorders of Gut-Brain Interaction (2016), IBS section. Available at theromefoundation.org. The 25% threshold applies only to abnormal-form stools, types 3-5 are considered “normal” in the criteria.

The four Rome IV IBS subtypes

IBS-C

Constipation predominant

>25% types 1-2 AND ≤25% types 6-7

IBS-D

Diarrhoea predominant

>25% types 6-7 AND ≤25% types 1-2

IBS-M

Mixed

>25% types 1-2 AND >25% types 6-7

IBS-U

Unsubtyped

≤25% types 1-2 AND ≤25% types 6-7

Why subtype matters for treatment

IBS treatment is subtype-directed. Soluble fibre and osmotic laxatives help IBS-C; loperamide and bile-acid sequestrants help IBS-D; low-FODMAP eating helps all subtypes but the specific triggers differ. Antispasmodics and gut-brain axis treatments (low-dose tricyclics, gut-directed CBT) help across subtypes.

Knowing your subtype lets your clinician pick the right first-line treatment instead of working through trials. The classifier output is meant for you to take to that conversation, “my 14-day pattern shows IBS-M with 28% type 1-2 and 42% type 6-7” gives your GP or gastroenterologist a much faster starting point than “sometimes constipated, sometimes loose”.

Important: this is a classifier, not a diagnosis

IBS is a diagnosis of exclusion. Blood in stool, unexplained weight loss, family history of bowel cancer or inflammatory bowel disease, persistent symptoms over age 50, or any change from a long-standing baseline all need clinician investigation. This tool is for clarifying which subtype fits your pattern once IBS is already a working diagnosis, not for determining whether you have IBS in the first place.

Updated 2026-04-27