GI ToolsGastroenterology and hepatology

Narcotic bowel syndrome (Rome IV)

Narcotic bowel syndrome is paradoxical worsening of abdominal pain with continued or increasing opioids. The Rome IV criteria are summarised here in our own words, and are a guide to a positive diagnosis alongside appropriate investigation. See the Rome Foundation for the original criteria.

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Reference

Keefer L, Drossman DA, Guthrie E, et al. Centrally mediated disorders of gastrointestinal pain. Gastroenterology. 2016;150(6):1408-1419.