GI · LIVE
Rome IV E1 biliary pain
Rome IV biliary pain
Apply the Cotton 2016 Rome IV E1 diagnostic criteria for biliary pain and return whether the published biliary-pain box holds (rome_iv_biliary_pain) plus three supportive flags.
Markdown: /docs/rome-iv-biliary-pain.md · Canonical: https://magentlab.com/docs/rome-iv-biliary-pain
Not a medical device. Not a diagnosis, dose, or listing recommendation.
What it computes
Apply the Cotton 2016 Rome IV E1 diagnostic criteria for biliary pain and return whether the published biliary-pain box holds (rome_iv_biliary_pain) plus three supportive flags.
When to use
When an agent already has the nine caller-assigned Cotton 2016 Rome IV E1 biliary-pain flags and needs whether the published biliary-pain box holds. magent does not examine the patient or read ultrasound, HIDA, or ERCP.
When not to use
- Not a medical device.
- Not a diagnosis. magent does not diagnose biliary pain or biliary disease.
- The caller assigns the nine flags. magent does not examine the patient or read ultrasound, HIDA, or ERCP.
- This tool is Cotton 2016 Rome IV E1 biliary pain only. nausea_and_vomiting, radiation_to_back_or_right_infra_subscapular, and waking_from_sleep are supportive and not required. Not functional gallbladder disorder. Not biliary sphincter of Oddi disorder. Not pancreatic sphincter of Oddi disorder.
Formula
rome_iv_biliary_pain iff epigastric_or_ruq_pain and builds_to_steady_level_lasts_30_min_or_longer and occurring_at_different_intervals_not_daily and severe_enough_to_interrupt_activities_or_ed_visit and not_significantly_related_to_bowel_movements and not_significantly_relieved_by_postural_change_or_acid_suppression (Cotton 2016 Rome IV E1 biliary pain). Supportive nausea_and_vomiting, radiation_to_back_or_right_infra_subscapular, waking_from_sleep are reported and not required.
Citation
- Authors
- Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES
- Source
- Gastroenterology. 2016;150(6):1420-1429
Worked example
Six required flags and three supportive flags
Given:
builds_to_steady_level_lasts_30_min_or_longer=trueepigastric_or_ruq_pain=truenausea_and_vomiting=truenot_significantly_related_to_bowel_movements=truenot_significantly_relieved_by_postural_change_or_acid_suppression=trueoccurring_at_different_intervals_not_daily=trueradiation_to_back_or_right_infra_subscapular=truesevere_enough_to_interrupt_activities_or_ed_visit=truewaking_from_sleep=true
- Pain located in the epigastrium and/or right upper quadrant is true
- Pain builds to a steady level lasting 30 minutes or longer is true
- Pain occurring at different intervals (not daily) is true
- Pain severe enough to interrupt daily activities or lead to an ED visit is true
- Pain not significantly related to bowel movements is true
- Pain not significantly relieved by postural change or acid suppression is true
- Nausea and vomiting, radiation to the back or right infra subscapular region, and waking from sleep are true (supportive, not required)
- rome_iv_biliary_pain is true
Six required flags without supportive flags
Given:
builds_to_steady_level_lasts_30_min_or_longer=trueepigastric_or_ruq_pain=truenausea_and_vomiting=falsenot_significantly_related_to_bowel_movements=truenot_significantly_relieved_by_postural_change_or_acid_suppression=trueoccurring_at_different_intervals_not_daily=trueradiation_to_back_or_right_infra_subscapular=falsesevere_enough_to_interrupt_activities_or_ed_visit=truewaking_from_sleep=false
- All six required E1 flags hold
- All three supportive flags are false
- rome_iv_biliary_pain is true because supportive flags are reported and not required
Also searched as
- Rome IV biliary pain
- Cotton 2016 biliary pain
- Rome IV E1 biliary pain
- biliary pain diagnostic criteria
- epigastric right upper quadrant pain
- gallbladder pain Rome IV
- Rome IV gallbladder biliary pain
- Cotton gallbladder sphincter of Oddi
Try
Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.
Full URL: https://api.magentlab.com/api/calc/rome_iv_biliary_pain?epigastric_or_ruq_pain=true&builds_to_steady_level_lasts_30_min_or_longer=true&occurring_at_different_intervals_not_daily=true&severe_enough_to_interrupt_activities_or_ed_visit=true¬_significantly_related_to_bowel_movements=true¬_significantly_relieved_by_postural_change_or_acid_suppression=true&nausea_and_vomiting=true&radiation_to_back_or_right_infra_subscapular=true&waking_from_sleep=true
Call
Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params
return HTTP 400 before any quote or charge.
curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/rome_iv_biliary_pain?epigastric_or_ruq_pain=true&builds_to_steady_level_lasts_30_min_or_longer=true&occurring_at_different_intervals_not_daily=true&severe_enough_to_interrupt_activities_or_ed_visit=true¬_significantly_related_to_bowel_movements=true¬_significantly_relieved_by_postural_change_or_acid_suppression=true&nausea_and_vomiting=true&radiation_to_back_or_right_infra_subscapular=true&waking_from_sleep=true"
Parameters
| Name | Type | Required | Description |
|---|---|---|---|
epigastric_or_ruq_pain |
boolean | required | Pain located in the epigastrium and/or right upper quadrant (Cotton 2016 Rome IV E1 biliary pain). true or false as assigned by the caller. magent does not examine the patient. |
builds_to_steady_level_lasts_30_min_or_longer |
boolean | required | Pain builds up to a steady level and lasts 30 minutes or longer, as assigned (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
occurring_at_different_intervals_not_daily |
boolean | required | Pain occurring at different intervals (not daily), as assigned (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
severe_enough_to_interrupt_activities_or_ed_visit |
boolean | required | Pain severe enough to interrupt daily activities or lead to an emergency department visit, as assigned (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
not_significantly_related_to_bowel_movements |
boolean | required | Pain not significantly (<20%) related to bowel movements, as assigned (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
not_significantly_relieved_by_postural_change_or_acid_suppression |
boolean | required | Pain not significantly (<20%) relieved by postural change or acid suppression, as assigned (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
nausea_and_vomiting |
boolean | required | Pain may be associated with nausea and vomiting, a supportive criterion that is not required for rome_iv_biliary_pain (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
radiation_to_back_or_right_infra_subscapular |
boolean | required | Pain may radiate to the back and/or right infra subscapular region, a supportive criterion that is not required for rome_iv_biliary_pain (Cotton 2016). true or false as assigned by the caller. magent does not examine the patient. |
waking_from_sleep |
boolean | required | Pain may wake the patient from sleep, a supportive criterion that is not required for rome_iv_biliary_pain (Cotton 2016). true or false as assigned by the caller. magent does not take a history. |
Bulk (POST)
POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.
- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.
Example request (fixture)
{
"items": [
{
"builds_to_steady_level_lasts_30_min_or_longer": "true",
"epigastric_or_ruq_pain": "true",
"nausea_and_vomiting": "true",
"not_significantly_related_to_bowel_movements": "true",
"not_significantly_relieved_by_postural_change_or_acid_suppression": "true",
"occurring_at_different_intervals_not_daily": "true",
"radiation_to_back_or_right_infra_subscapular": "true",
"severe_enough_to_interrupt_activities_or_ed_visit": "true",
"waking_from_sleep": "true"
},
{
"builds_to_steady_level_lasts_30_min_or_longer": "true",
"epigastric_or_ruq_pain": "true",
"nausea_and_vomiting": "true",
"not_significantly_related_to_bowel_movements": "true",
"not_significantly_relieved_by_postural_change_or_acid_suppression": "true",
"occurring_at_different_intervals_not_daily": "true",
"radiation_to_back_or_right_infra_subscapular": "true",
"severe_enough_to_interrupt_activities_or_ed_visit": "true",
"waking_from_sleep": "true"
}
]
}
Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.
Example 200 (fixture)
{
"count": 2,
"path": "/api/calc/rome_iv_biliary_pain",
"items": [
{
"disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
"citation": {
"authors": "Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES",
"doi": "10.1053/j.gastro.2016.02.033",
"id": "cotton-2016",
"pmid": "27144629",
"source": "Gastroenterology. 2016;150(6):1420-1429",
"title": "Gallbladder and Sphincter of Oddi Disorders"
},
"formula": "rome_iv_biliary_pain",
"formula_expression": "rome_iv_biliary_pain iff epigastric_or_ruq_pain and builds_to_steady_level_lasts_30_min_or_longer and occurring_at_different_intervals_not_daily and severe_enough_to_interrupt_activities_or_ed_visit and not_significantly_related_to_bowel_movements and not_significantly_relieved_by_postural_change_or_acid_suppression (Cotton 2016 Rome IV E1 biliary pain). Supportive nausea_and_vomiting, radiation_to_back_or_right_infra_subscapular, waking_from_sleep are reported and not required.",
"criteria": [
{
"factor": "epigastric_or_ruq_pain",
"met": true
},
{
"factor": "builds_to_steady_level_lasts_30_min_or_longer",
"met": true
},
{
"factor": "occurring_at_different_intervals_not_daily",
"met": true
},
{
"factor": "severe_enough_to_interrupt_activities_or_ed_visit",
"met": true
},
{
"factor": "not_significantly_related_to_bowel_movements",
"met": true
},
{
"factor": "not_significantly_relieved_by_postural_change_or_acid_suppression",
"met": true
},
{
"factor": "nausea_and_vomiting",
"met": true
},
{
"factor": "radiation_to_back_or_right_infra_subscapular",
"met": true
},
{
"factor": "waking_from_sleep",
"met": true
}
],
"nausea_and_vomiting": true,
"radiation_to_back_or_right_infra_subscapular": true,
"rome_iv_biliary_pain": true,
"waking_from_sleep": true
},
{
"disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
"citation": {
"authors": "Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES",
"doi": "10.1053/j.gastro.2016.02.033",
"id": "cotton-2016",
"pmid": "27144629",
"source": "Gastroenterology. 2016;150(6):1420-1429",
"title": "Gallbladder and Sphincter of Oddi Disorders"
},
"formula": "rome_iv_biliary_pain",
"formula_expression": "rome_iv_biliary_pain iff epigastric_or_ruq_pain and builds_to_steady_level_lasts_30_min_or_longer and occurring_at_different_intervals_not_daily and severe_enough_to_interrupt_activities_or_ed_visit and not_significantly_related_to_bowel_movements and not_significantly_relieved_by_postural_change_or_acid_suppression (Cotton 2016 Rome IV E1 biliary pain). Supportive nausea_and_vomiting, radiation_to_back_or_right_infra_subscapular, waking_from_sleep are reported and not required.",
"criteria": [
{
"factor": "epigastric_or_ruq_pain",
"met": true
},
{
"factor": "builds_to_steady_level_lasts_30_min_or_longer",
"met": true
},
{
"factor": "occurring_at_different_intervals_not_daily",
"met": true
},
{
"factor": "severe_enough_to_interrupt_activities_or_ed_visit",
"met": true
},
{
"factor": "not_significantly_related_to_bowel_movements",
"met": true
},
{
"factor": "not_significantly_relieved_by_postural_change_or_acid_suppression",
"met": true
},
{
"factor": "nausea_and_vomiting",
"met": true
},
{
"factor": "radiation_to_back_or_right_infra_subscapular",
"met": true
},
{
"factor": "waking_from_sleep",
"met": true
}
],
"nausea_and_vomiting": true,
"radiation_to_back_or_right_infra_subscapular": true,
"rome_iv_biliary_pain": true,
"waking_from_sleep": true
}
]
}
Response
| Field | Type | Description |
|---|---|---|
formula |
string | rome_iv_biliary_pain |
formula_expression |
string | Cotton 2016 Rome IV E1 biliary pain: epigastric or RUQ pain that builds to a steady level lasting 30 minutes or longer, occurs at different intervals (not daily), is severe enough to interrupt daily activities or lead to an ED visit, is not significantly related to bowel movements, and is not significantly relieved by postural change or acid suppression; nausea_and_vomiting, radiation_to_back_or_right_infra_subscapular, and waking_from_sleep are supportive and not required |
nausea_and_vomiting |
boolean | Caller-assigned supportive nausea and vomiting flag. Reported separately; not required for rome_iv_biliary_pain. |
radiation_to_back_or_right_infra_subscapular |
boolean | Caller-assigned supportive radiation to the back and/or right infra subscapular region. Reported separately; not required for rome_iv_biliary_pain. |
waking_from_sleep |
boolean | Caller-assigned supportive waking from sleep flag. Reported separately; not required for rome_iv_biliary_pain. |
rome_iv_biliary_pain |
boolean | true only when all six required E1 flags hold. Supportive flags are not required. Not a diagnosis. |
criteria |
array | Per-factor rows with factor and met for the six required E1 flags plus three supportive flags |
citation |
object | Cotton 2016 Gastroenterology citation |
disclaimer |
string | Not-a-device notice |
Example JSON
Machine form of the same example. Frozen fixture. Not a live lookup.
{
"disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
"citation": {
"authors": "Cotton PB, Elta GH, Carter CR, Pasricha PJ, Corazziari ES",
"doi": "10.1053/j.gastro.2016.02.033",
"id": "cotton-2016",
"pmid": "27144629",
"source": "Gastroenterology. 2016;150(6):1420-1429",
"title": "Gallbladder and Sphincter of Oddi Disorders"
},
"formula": "rome_iv_biliary_pain",
"formula_expression": "rome_iv_biliary_pain iff epigastric_or_ruq_pain and builds_to_steady_level_lasts_30_min_or_longer and occurring_at_different_intervals_not_daily and severe_enough_to_interrupt_activities_or_ed_visit and not_significantly_related_to_bowel_movements and not_significantly_relieved_by_postural_change_or_acid_suppression (Cotton 2016 Rome IV E1 biliary pain). Supportive nausea_and_vomiting, radiation_to_back_or_right_infra_subscapular, waking_from_sleep are reported and not required.",
"criteria": [
{
"factor": "epigastric_or_ruq_pain",
"met": true
},
{
"factor": "builds_to_steady_level_lasts_30_min_or_longer",
"met": true
},
{
"factor": "occurring_at_different_intervals_not_daily",
"met": true
},
{
"factor": "severe_enough_to_interrupt_activities_or_ed_visit",
"met": true
},
{
"factor": "not_significantly_related_to_bowel_movements",
"met": true
},
{
"factor": "not_significantly_relieved_by_postural_change_or_acid_suppression",
"met": true
},
{
"factor": "nausea_and_vomiting",
"met": true
},
{
"factor": "radiation_to_back_or_right_infra_subscapular",
"met": true
},
{
"factor": "waking_from_sleep",
"met": true
}
],
"nausea_and_vomiting": true,
"radiation_to_back_or_right_infra_subscapular": true,
"rome_iv_biliary_pain": true,
"waking_from_sleep": true
}
Client errors (HTTP 400)
Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.
| HTTP | Code | When |
|---|---|---|
| 400 | invalid_rome_iv_biliary_pain |
Rome IV biliary pain needs the Cotton 2016 gallbladder and sphincter-of-Oddi pain flags. Returned before settlement; you are not charged. |
| 400 | invalid_flag |
boolean clinical flags must be true or false Returned before settlement; you are not charged. |
| 400 | invalid_items |
POST body must be a JSON object with only an items array Returned before settlement; you are not charged. |
| 400 | invalid_item_count |
items must be an array of 1 to 25 objects Returned before settlement; you are not charged. |
| 400 | invalid_item |
each items entry must be a JSON object Returned before settlement; you are not charged. |
Related tools
- Rome IV FGBD — Apply the Cotton 2016 Rome IV E1a functional gallbladder disorder diagnostic criteria and return whether the published E1a box holds (rome_iv_functional_gallbladder) plus the two supportive flags.
- Rome IV biliary SOD — Apply the Cotton 2016 Rome IV E1b functional biliary sphincter of Oddi disorder diagnostic criteria and return whether the published E1b box holds (rome_iv_biliary_sod). Elevated liver enzymes XOR dilated bile duct is required. Supportive flags are reported and not required.
Payment
Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64
PAYMENT-REQUIRED
header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake
and shared payment errors: Payments.
Stdio MCP: /docs/mcp.
Guarantees
- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.