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Rome III versus Rome IV criteria for IBS 37 2 into account asymmetric distribution of the data. A P -value of <0.05 was considered statistically significant. Results Study population In total, 404 subjects that completed at least 12 days of the end-of-day symptom diary were included in the analyses: 293 (72.5%) were women and median age was 45 [IQR: 28-59] years. Seventy-two per cent ( N =291) was recruited from secondary/tertiary care and IBS subtypes (based on Rome III criteria) were distributed as follows: 140 (34.7%) IBS-D, 81 (20%) IBS-C, 159 (39.4%) IBS-M and 24 (5.9%) IBS-U. Further characteristics of the total study population are shown in Table 2.1 . IBS according to Rome IV criteria – Definition 1: Abdominal pain score ≥2 Of the 404 IBS subjects diagnosed by Rome III criteria, 353 (87.4%) did meet the surrogate Rome IV criteria when assessed using the end-of-day symptom diary and the cut-off for abdominal pain severity of ≥2. Rome IV-positive subjects were more often female (74.5% vs. 58.8%, P <0.05), younger (45 vs. 53 years, P <0.05) and recruited from secondary/tertiary care (74.4% vs. 56.9%, P <0.05) compared to Rome IV-negative subjects. Additionally, visceral hypersensitivity assessed by rectal barostat was present more often in Rome IV-positive subjects (47.5% vs. 11.8%, P <0.001). Subtype distribution ( i.e. based on Rome III criteria) was not different between both groups.