The role of BAD in Rome IV

Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, sex, race, creed, color, or socioeconomic status. ¹

IBS most commonly affects people between the ages of 20 and 30 years and is twice as common in women as in men. The prevalence of the condition in the general population is estimated at between 9.8 and 12.8%. ¹

IBS is classified into 3 main subtypes according to the predominant disorder in bowel habits: IBS-C, IBS-D, and IBS-M. ¹

Diagnostic process ¹

Patients should be questioned about their diet, with special attention paid to the ingestion of dairy products, wheat, caffeine, fruits, vegetables, juices, sweetened soft drinks, and chewing gum, because these can mimic or exacerbate IBS symptoms.
Then a physical examination should be performed in every patient evaluated for IBS.
The third step in the diagnosis of IBS is to perform limited laboratory studies, if not previously performed.
A screening colonoscopy is indicated in patients 50 years and older in the absence of warning signs, based on national recommendations.
Bile acid malabsorption may be the cause of persistent, watery diarrhoea in some patients. If empiric therapy fails, scintigraphic evaluation (75SeHCAT test) is a diagnostic option.
There is increasing evidence to support a role for bile acids in the pathophysiology of IBS-D.
Bile acid malabsorption, is an often overlooked diagnosis in patients with longstanding diarrhoea, which can be identified, using 75SeHCAT, when available. (ROME IV Criteria Functional GI Disorders, 2016)

More Information can be found here: https://theromefoundation.org/rome-iv/rome-iv-journal-articles/

References:

Rome IV Criteria: Lacy et al. Gastroenterology 2016; 150:1393-1407 Vol. 150, No. 6