GI · LIVE

Rome IV opioid-induced constipation

Rome IV OIC

Apply the Mearin 2016 Rome IV C6 opioid-induced constipation criteria and return symptom_count (0-6) and whether the published C6 box holds (rome_iv_oic).

LIVE $0.005 USDC GET /api/calc/rome_iv_oic

Markdown: /docs/rome-iv-oic.md · Canonical: https://magentlab.com/docs/rome-iv-oic

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Apply the Mearin 2016 Rome IV C6 opioid-induced constipation criteria and return symptom_count (0-6) and whether the published C6 box holds (rome_iv_oic).

When to use

When an agent already has the eight caller-assigned Rome IV C6 flags as in Mearin 2016 and needs whether the published opioid-induced constipation box holds. magent does not examine the patient or prescribe opioids.

When not to use

Not a medical device.
Not a diagnosis. magent does not diagnose opioid-induced constipation.
The caller assigns the eight flags. magent does not examine the patient.
This tool is adult Rome IV C6 opioid-induced constipation only. Not functional constipation C2 (rome-iv-fc is a different tool), not Rome IV IBS, and not child. magent does not prescribe opioids.

Formula

rome_iv_oic iff new_or_worsening_constipation_on_opioid_change and symptom_count >= 2 and loose_stools_rare_without_laxatives; symptom_count counts straining_gt_25_percent, lumpy_or_hard_stools_gt_25_percent, incomplete_evacuation_gt_25_percent, anorectal_obstruction_gt_25_percent, manual_maneuvers_gt_25_percent, and fewer_than_3_sbm_per_week (Mearin 2016 Rome IV C6 opioid-induced constipation)

Citation

Title: Bowel Disorders
Authors: Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller RC
Source: Gastroenterology. 2016;150(6):1393-1407
DOI: 10.1053/j.gastro.2016.02.031

Worked example

Opioid change, two of six symptoms, and rare loose stools

Given: anorectal_obstruction_gt_25_percent=falsefewer_than_3_sbm_per_week=trueincomplete_evacuation_gt_25_percent=falseloose_stools_rare_without_laxatives=truelumpy_or_hard_stools_gt_25_percent=falsemanual_maneuvers_gt_25_percent=falsenew_or_worsening_constipation_on_opioid_change=truestraining_gt_25_percent=true

New or worsening constipation when initiating, changing, or increasing opioid therapy is true
Straining more than 25% of defecations and fewer than 3 spontaneous bowel movements per week are true; the other four symptom items are false (2 of 6)
Loose stools rarely present without laxatives is true
rome_iv_oic is true

Opioid change and rare loose stools with only one symptom

Given: anorectal_obstruction_gt_25_percent=falsefewer_than_3_sbm_per_week=falseincomplete_evacuation_gt_25_percent=falseloose_stools_rare_without_laxatives=truelumpy_or_hard_stools_gt_25_percent=falsemanual_maneuvers_gt_25_percent=falsenew_or_worsening_constipation_on_opioid_change=truestraining_gt_25_percent=true

Opioid-change constipation and rare loose stools without laxatives hold
Only straining is true (1 of 6)
rome_iv_oic is false

Also searched as

Rome IV opioid-induced constipation
Rome IV C6
Mearin 2016 OIC
opioid-induced constipation criteria
Rome IV OIC
adult opioid-induced constipation
OIC Rome IV
Mearin C6 opioid constipation

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/rome_iv_oic?new_or_worsening_constipation_on_opioid_change=true&straining_gt_25_percent=true&lumpy_or_hard_stools_gt_25_percent=false&incomplete_evacuation_gt_25_percent=false&anorectal_obstruction_gt_25_percent=false&manual_maneuvers_gt_25_percent=false&fewer_than_3_sbm_per_week=true&loose_stools_rare_without_laxatives=true

Full URL: https://api.magentlab.com/api/calc/rome_iv_oic?new_or_worsening_constipation_on_opioid_change=true&straining_gt_25_percent=true&lumpy_or_hard_stools_gt_25_percent=false&incomplete_evacuation_gt_25_percent=false&anorectal_obstruction_gt_25_percent=false&manual_maneuvers_gt_25_percent=false&fewer_than_3_sbm_per_week=true&loose_stools_rare_without_laxatives=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_oic?new_or_worsening_constipation_on_opioid_change=true&straining_gt_25_percent=true&lumpy_or_hard_stools_gt_25_percent=false&incomplete_evacuation_gt_25_percent=false&anorectal_obstruction_gt_25_percent=false&manual_maneuvers_gt_25_percent=false&fewer_than_3_sbm_per_week=true&loose_stools_rare_without_laxatives=true"

Parameters

Name	Type	Required	Description
`new_or_worsening_constipation_on_opioid_change`	boolean	required	New or worsening constipation when initiating, changing, or increasing opioid therapy, as assigned (Mearin 2016 C6). true or false as assigned by the caller. magent does not take a history or prescribe opioids.
`straining_gt_25_percent`	boolean	required	Straining during more than 25% of defecations (one of six C6 symptom items; at least two required). true or false as assigned by the caller. magent does not examine the patient.
`lumpy_or_hard_stools_gt_25_percent`	boolean	required	Lumpy or hard stools (Bristol stool form types 1-2) more than 25% of defecations (one of six C6 symptom items; at least two required). true or false as assigned by the caller. magent does not inspect stool.
`incomplete_evacuation_gt_25_percent`	boolean	required	Sensation of incomplete evacuation more than 25% of defecations (one of six C6 symptom items; at least two required). true or false as assigned by the caller.
`anorectal_obstruction_gt_25_percent`	boolean	required	Sensation of anorectal obstruction/blockage more than 25% of defecations (one of six C6 symptom items; at least two required). true or false as assigned by the caller.
`manual_maneuvers_gt_25_percent`	boolean	required	Manual maneuvers to facilitate more than 25% of defecations (one of six C6 symptom items; at least two required). true or false as assigned by the caller.
`fewer_than_3_sbm_per_week`	boolean	required	Fewer than three spontaneous bowel movements per week (one of six C6 symptom items; at least two required). true or false as assigned by the caller.
`loose_stools_rare_without_laxatives`	boolean	required	Loose stools are rarely present without the use of laxatives, as assigned (Mearin 2016 C6). true or false as assigned by the caller. magent does not examine the patient.

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.

POST /api/calc/rome_iv_oic Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

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": [
    {
      "anorectal_obstruction_gt_25_percent": "false",
      "fewer_than_3_sbm_per_week": "true",
      "incomplete_evacuation_gt_25_percent": "false",
      "loose_stools_rare_without_laxatives": "true",
      "lumpy_or_hard_stools_gt_25_percent": "false",
      "manual_maneuvers_gt_25_percent": "false",
      "new_or_worsening_constipation_on_opioid_change": "true",
      "straining_gt_25_percent": "true"
    },
    {
      "anorectal_obstruction_gt_25_percent": "false",
      "fewer_than_3_sbm_per_week": "true",
      "incomplete_evacuation_gt_25_percent": "false",
      "loose_stools_rare_without_laxatives": "true",
      "lumpy_or_hard_stools_gt_25_percent": "false",
      "manual_maneuvers_gt_25_percent": "false",
      "new_or_worsening_constipation_on_opioid_change": "true",
      "straining_gt_25_percent": "true"
    }
  ]
}

Open bulk paywall →

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_oic",
  "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": "Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller RC",
        "doi": "10.1053/j.gastro.2016.02.031",
        "id": "mearin-2016",
        "pmid": "27144627",
        "source": "Gastroenterology. 2016;150(6):1393-1407",
        "title": "Bowel Disorders"
      },
      "formula": "rome_iv_oic",
      "formula_expression": "rome_iv_oic iff new_or_worsening_constipation_on_opioid_change and symptom_count >= 2 and loose_stools_rare_without_laxatives; symptom_count counts straining_gt_25_percent, lumpy_or_hard_stools_gt_25_percent, incomplete_evacuation_gt_25_percent, anorectal_obstruction_gt_25_percent, manual_maneuvers_gt_25_percent, and fewer_than_3_sbm_per_week (Mearin 2016 Rome IV C6 opioid-induced constipation)",
      "criteria": [
        {
          "factor": "new_or_worsening_constipation_on_opioid_change",
          "met": true
        },
        {
          "factor": "straining_gt_25_percent",
          "met": true
        },
        {
          "factor": "lumpy_or_hard_stools_gt_25_percent",
          "met": false
        },
        {
          "factor": "incomplete_evacuation_gt_25_percent",
          "met": false
        },
        {
          "factor": "anorectal_obstruction_gt_25_percent",
          "met": false
        },
        {
          "factor": "manual_maneuvers_gt_25_percent",
          "met": false
        },
        {
          "factor": "fewer_than_3_sbm_per_week",
          "met": true
        },
        {
          "value": 2,
          "factor": "symptom_count_ge_2",
          "met": true
        },
        {
          "factor": "loose_stools_rare_without_laxatives",
          "met": true
        }
      ],
      "symptom_count": 2,
      "rome_iv_oic": 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": "Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller RC",
        "doi": "10.1053/j.gastro.2016.02.031",
        "id": "mearin-2016",
        "pmid": "27144627",
        "source": "Gastroenterology. 2016;150(6):1393-1407",
        "title": "Bowel Disorders"
      },
      "formula": "rome_iv_oic",
      "formula_expression": "rome_iv_oic iff new_or_worsening_constipation_on_opioid_change and symptom_count >= 2 and loose_stools_rare_without_laxatives; symptom_count counts straining_gt_25_percent, lumpy_or_hard_stools_gt_25_percent, incomplete_evacuation_gt_25_percent, anorectal_obstruction_gt_25_percent, manual_maneuvers_gt_25_percent, and fewer_than_3_sbm_per_week (Mearin 2016 Rome IV C6 opioid-induced constipation)",
      "criteria": [
        {
          "factor": "new_or_worsening_constipation_on_opioid_change",
          "met": true
        },
        {
          "factor": "straining_gt_25_percent",
          "met": true
        },
        {
          "factor": "lumpy_or_hard_stools_gt_25_percent",
          "met": false
        },
        {
          "factor": "incomplete_evacuation_gt_25_percent",
          "met": false
        },
        {
          "factor": "anorectal_obstruction_gt_25_percent",
          "met": false
        },
        {
          "factor": "manual_maneuvers_gt_25_percent",
          "met": false
        },
        {
          "factor": "fewer_than_3_sbm_per_week",
          "met": true
        },
        {
          "value": 2,
          "factor": "symptom_count_ge_2",
          "met": true
        },
        {
          "factor": "loose_stools_rare_without_laxatives",
          "met": true
        }
      ],
      "symptom_count": 2,
      "rome_iv_oic": true
    }
  ]
}

Response

Field	Type	Description
`formula`	string	rome_iv_oic
`formula_expression`	string	Mearin 2016 Rome IV C6: new or worsening constipation on opioid change, at least 2 of 6 symptoms, and rare loose stools without laxatives
`symptom_count`	integer	Count of true C6 symptom items among straining, lumpy or hard stools, incomplete evacuation, anorectal obstruction, manual maneuvers, and fewer than 3 spontaneous bowel movements per week (0-6)
`rome_iv_oic`	boolean	true only when opioid-change constipation, at least two of six symptoms, and rare loose stools without laxatives all hold. Not a diagnosis.
`criteria`	array	Per-factor rows with factor and met; symptom_count_ge_2 includes value 0-6
`citation`	object	Mearin 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": "Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller RC",
    "doi": "10.1053/j.gastro.2016.02.031",
    "id": "mearin-2016",
    "pmid": "27144627",
    "source": "Gastroenterology. 2016;150(6):1393-1407",
    "title": "Bowel Disorders"
  },
  "formula": "rome_iv_oic",
  "formula_expression": "rome_iv_oic iff new_or_worsening_constipation_on_opioid_change and symptom_count >= 2 and loose_stools_rare_without_laxatives; symptom_count counts straining_gt_25_percent, lumpy_or_hard_stools_gt_25_percent, incomplete_evacuation_gt_25_percent, anorectal_obstruction_gt_25_percent, manual_maneuvers_gt_25_percent, and fewer_than_3_sbm_per_week (Mearin 2016 Rome IV C6 opioid-induced constipation)",
  "criteria": [
    {
      "factor": "new_or_worsening_constipation_on_opioid_change",
      "met": true
    },
    {
      "factor": "straining_gt_25_percent",
      "met": true
    },
    {
      "factor": "lumpy_or_hard_stools_gt_25_percent",
      "met": false
    },
    {
      "factor": "incomplete_evacuation_gt_25_percent",
      "met": false
    },
    {
      "factor": "anorectal_obstruction_gt_25_percent",
      "met": false
    },
    {
      "factor": "manual_maneuvers_gt_25_percent",
      "met": false
    },
    {
      "factor": "fewer_than_3_sbm_per_week",
      "met": true
    },
    {
      "value": 2,
      "factor": "symptom_count_ge_2",
      "met": true
    },
    {
      "factor": "loose_stools_rare_without_laxatives",
      "met": true
    }
  ],
  "symptom_count": 2,
  "rome_iv_oic": true
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
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 FC — Apply the Mearin 2016 Rome IV C2 functional constipation criteria and return symptom_count (0-6) and whether the published C2 box holds (rome_iv_fc).
Rome IV IBS — Apply the Mearin 2016 Rome IV IBS diagnostic criteria and return supporting_features_met (0-3) and whether the published IBS box holds (rome_iv_ibs).
Bristol stool — Return the Lewis 1997 Bristol stool form scale type 1-7 from a caller-assigned integer, with the published form wording.

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.