# Rome IV proctalgia fugax

Rao 2016 Rome IV proctalgia fugax

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/rome_iv_proctalgia_fugax`
HTML: https://magentlab.com/docs/rome-iv-proctalgia-fugax
Markdown: https://magentlab.com/docs/rome-iv-proctalgia-fugax.md

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

## What it computes

Apply the Rao 2016 Rome IV proctalgia fugax (F2c) diagnostic criteria and return whether the published proctalgia fugax box holds (rome_iv_proctalgia_fugax).

## When to use

When an agent already has the six caller-assigned Rao 2016 Rome IV proctalgia fugax flags and needs whether the published box holds. magent does not examine the rectum.

## When not to use

- Not a medical device.
- Not a diagnosis. magent does not diagnose proctalgia fugax.
- The caller assigns the six flags. magent does not examine the rectum.
- This tool is Rao 2016 Rome IV proctalgia fugax (F2c) only. Not levator ani syndrome (chronic or recurrent rectal pain lasting 30 minutes or longer with puborectalis tenderness). Not unspecified functional anorectal pain.

## Formula

```
rome_iv_proctalgia_fugax iff recurrent_rectal_pain_unrelated_to_defecation and episodes_seconds_to_minutes_max_30_minutes and no_anorectal_pain_between_episodes and other_causes_of_rectal_pain_excluded and fulfilled_last_3_months and onset_at_least_6_months (Rao 2016 Rome IV proctalgia fugax)
```

## Citation

[Anorectal Disorders](https://doi.org/10.1053/j.gastro.2016.02.009)
Rao SSC, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A, Wald A
Gastroenterology. 2016;150(6):1430-1442
DOI: [10.1053/j.gastro.2016.02.009](https://doi.org/10.1053/j.gastro.2016.02.009)

## Worked example

### All six required flags

Given: `episodes_seconds_to_minutes_max_30_minutes=true, fulfilled_last_3_months=true, no_anorectal_pain_between_episodes=true, onset_at_least_6_months=true, other_causes_of_rectal_pain_excluded=true, recurrent_rectal_pain_unrelated_to_defecation=true`

1. Recurrent rectal pain unrelated to defecation is true
2. Episodes last seconds to minutes with a maximum of 30 minutes
3. No anorectal pain between episodes is true
4. Other causes of rectal pain are excluded
5. Criteria fulfilled for the last 3 months and onset at least 6 months prior are true
6. rome_iv_proctalgia_fugax is true


### Five required flags without 6-month onset

Given: `episodes_seconds_to_minutes_max_30_minutes=true, fulfilled_last_3_months=true, no_anorectal_pain_between_episodes=true, onset_at_least_6_months=false, other_causes_of_rectal_pain_excluded=true, recurrent_rectal_pain_unrelated_to_defecation=true`

1. Five required flags hold
2. Onset at least 6 months prior is false
3. rome_iv_proctalgia_fugax is false


## Also searched as

- Rome IV proctalgia fugax
- Rao 2016 proctalgia fugax
- proctalgia fugax Rome IV
- Rome IV F2c
- brief rectal pain Rome IV
- proctalgia fugax criteria
- Rome IV anorectal proctalgia
- functional anorectal pain fugax

## Parameters

- `recurrent_rectal_pain_unrelated_to_defecation` (boolean, required): Recurrent episodes of rectal pain unrelated to defecation, as assigned (Rao 2016 Rome IV proctalgia fugax F2c). true or false as assigned by the caller. magent does not examine the rectum.
- `episodes_seconds_to_minutes_max_30_minutes` (boolean, required): Episodes last from seconds to minutes, with a maximum duration of 30 minutes, as assigned (Rao 2016 F2c). Distinguishes proctalgia fugax from levator ani syndrome (pain lasting 30 minutes or longer). true or false as assigned by the caller. magent does not examine the rectum.
- `no_anorectal_pain_between_episodes` (boolean, required): Absence of anorectal pain between episodes, as assigned (Rao 2016). true or false as assigned by the caller. magent does not examine the rectum.
- `other_causes_of_rectal_pain_excluded` (boolean, required): Other causes of rectal pain excluded as assigned: inflammatory bowel disease, intramuscular abscess, anal fissure, thrombosed hemorrhoids, prostatitis, coccygodynia, and major structural alterations of the pelvic floor (Rao 2016). true or false as assigned by the caller. magent does not examine the rectum.
- `fulfilled_last_3_months` (boolean, required): Criteria fulfilled for the last 3 months, as assigned (Rao 2016). true or false as assigned by the caller. magent does not take a history.
- `onset_at_least_6_months` (boolean, required): Symptom onset at least 6 months prior to diagnosis, as assigned (Rao 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.

Method: `POST /api/calc/rome_iv_proctalgia_fugax`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: 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:

```json
{
  "items": [
    {
      "episodes_seconds_to_minutes_max_30_minutes": "true",
      "fulfilled_last_3_months": "true",
      "no_anorectal_pain_between_episodes": "true",
      "onset_at_least_6_months": "true",
      "other_causes_of_rectal_pain_excluded": "true",
      "recurrent_rectal_pain_unrelated_to_defecation": "true"
    },
    {
      "episodes_seconds_to_minutes_max_30_minutes": "true",
      "fulfilled_last_3_months": "true",
      "no_anorectal_pain_between_episodes": "true",
      "onset_at_least_6_months": "true",
      "other_causes_of_rectal_pain_excluded": "true",
      "recurrent_rectal_pain_unrelated_to_defecation": "true"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/rome-iv-proctalgia-fugax

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/rome_iv_proctalgia_fugax",
  "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": "Rao SSC, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A, Wald A",
        "doi": "10.1053/j.gastro.2016.02.009",
        "id": "rao-2016",
        "pmid": "27144630",
        "source": "Gastroenterology. 2016;150(6):1430-1442",
        "title": "Anorectal Disorders"
      },
      "formula": "rome_iv_proctalgia_fugax",
      "formula_expression": "rome_iv_proctalgia_fugax iff recurrent_rectal_pain_unrelated_to_defecation and episodes_seconds_to_minutes_max_30_minutes and no_anorectal_pain_between_episodes and other_causes_of_rectal_pain_excluded and fulfilled_last_3_months and onset_at_least_6_months (Rao 2016 Rome IV proctalgia fugax)",
      "criteria": [
        {
          "factor": "recurrent_rectal_pain_unrelated_to_defecation",
          "met": true
        },
        {
          "factor": "episodes_seconds_to_minutes_max_30_minutes",
          "met": true
        },
        {
          "factor": "no_anorectal_pain_between_episodes",
          "met": true
        },
        {
          "factor": "other_causes_of_rectal_pain_excluded",
          "met": true
        },
        {
          "factor": "fulfilled_last_3_months",
          "met": true
        },
        {
          "factor": "onset_at_least_6_months",
          "met": true
        }
      ],
      "rome_iv_proctalgia_fugax": 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": "Rao SSC, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A, Wald A",
        "doi": "10.1053/j.gastro.2016.02.009",
        "id": "rao-2016",
        "pmid": "27144630",
        "source": "Gastroenterology. 2016;150(6):1430-1442",
        "title": "Anorectal Disorders"
      },
      "formula": "rome_iv_proctalgia_fugax",
      "formula_expression": "rome_iv_proctalgia_fugax iff recurrent_rectal_pain_unrelated_to_defecation and episodes_seconds_to_minutes_max_30_minutes and no_anorectal_pain_between_episodes and other_causes_of_rectal_pain_excluded and fulfilled_last_3_months and onset_at_least_6_months (Rao 2016 Rome IV proctalgia fugax)",
      "criteria": [
        {
          "factor": "recurrent_rectal_pain_unrelated_to_defecation",
          "met": true
        },
        {
          "factor": "episodes_seconds_to_minutes_max_30_minutes",
          "met": true
        },
        {
          "factor": "no_anorectal_pain_between_episodes",
          "met": true
        },
        {
          "factor": "other_causes_of_rectal_pain_excluded",
          "met": true
        },
        {
          "factor": "fulfilled_last_3_months",
          "met": true
        },
        {
          "factor": "onset_at_least_6_months",
          "met": true
        }
      ],
      "rome_iv_proctalgia_fugax": true
    }
  ]
}
```

## Response fields

- `formula` (string): rome_iv_proctalgia_fugax
- `formula_expression` (string): Rao 2016 Rome IV proctalgia fugax F2c: recurrent rectal pain unrelated to defecation, episodes lasting seconds to minutes with a maximum of 30 minutes, no anorectal pain between episodes, other causes of rectal pain excluded, last-3-months criteria, and 6-month onset
- `rome_iv_proctalgia_fugax` (boolean): true only when all six required flags hold. Not a diagnosis.
- `criteria` (array): Per-factor rows with factor and met for the six required flags
- `citation` (object): Rao 2016 Gastroenterology citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "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": "Rao SSC, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A, Wald A",
    "doi": "10.1053/j.gastro.2016.02.009",
    "id": "rao-2016",
    "pmid": "27144630",
    "source": "Gastroenterology. 2016;150(6):1430-1442",
    "title": "Anorectal Disorders"
  },
  "formula": "rome_iv_proctalgia_fugax",
  "formula_expression": "rome_iv_proctalgia_fugax iff recurrent_rectal_pain_unrelated_to_defecation and episodes_seconds_to_minutes_max_30_minutes and no_anorectal_pain_between_episodes and other_causes_of_rectal_pain_excluded and fulfilled_last_3_months and onset_at_least_6_months (Rao 2016 Rome IV proctalgia fugax)",
  "criteria": [
    {
      "factor": "recurrent_rectal_pain_unrelated_to_defecation",
      "met": true
    },
    {
      "factor": "episodes_seconds_to_minutes_max_30_minutes",
      "met": true
    },
    {
      "factor": "no_anorectal_pain_between_episodes",
      "met": true
    },
    {
      "factor": "other_causes_of_rectal_pain_excluded",
      "met": true
    },
    {
      "factor": "fulfilled_last_3_months",
      "met": true
    },
    {
      "factor": "onset_at_least_6_months",
      "met": true
    }
  ],
  "rome_iv_proctalgia_fugax": true
}
```

## Errors

- HTTP 400 `invalid_rome_iv_proctalgia_fugax`: Rome IV proctalgia fugax needs the Rao 2016 anorectal proctalgia-fugax flags. Returned before settlement; you are not charged.
- HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [Rao 2016 Rome IV levator ani syndrome](https://magentlab.com/docs/rome-iv-levator-ani) — Apply the Rao 2016 Rome IV levator ani syndrome (F2a) diagnostic criteria and return whether the published levator ani box holds (rome_iv_levator_ani).
- [Rome IV FC](https://magentlab.com/docs/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).

## 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.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/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.