# Rome IV unspecified functional bowel

Rome IV Unspecified Bowel

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/rome_iv_unspecified_bowel`
HTML: https://magentlab.com/docs/rome-iv-unspecified-bowel
Markdown: https://magentlab.com/docs/rome-iv-unspecified-bowel.md

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

## What it computes

Apply the Mearin 2016 Rome IV C5 unspecified functional bowel disorder criteria and return whether the published residual C5 box holds (rome_iv_unspecified_bowel).

## When to use

When an agent already has the seven caller-assigned Mearin 2016 Rome IV C5 flags and needs whether the published unspecified functional bowel box holds. magent does not examine the patient or re-score IBS, functional constipation, functional diarrhea, or bloating/distension.

## When not to use

- Not a medical device.
- Not a diagnosis. magent does not diagnose unspecified functional bowel disorder.
- The caller assigns the seven flags. magent does not examine the patient or re-score IBS, functional constipation, functional diarrhea, or functional bloating/distension.
- This tool is residual Mearin 2016 Rome IV C5 unspecified functional bowel disorder only. Not IBS, not functional constipation, not functional diarrhea, and not functional bloating/distension.

## Formula

```
rome_iv_unspecified_bowel iff bowel_symptoms_not_attributable_to_organic_etiology and does_not_meet_criteria_for_ibs and does_not_meet_criteria_for_functional_constipation and does_not_meet_criteria_for_functional_diarrhea and does_not_meet_criteria_for_functional_bloating_distension and fulfilled_last_3_months and onset_at_least_6_months (Mearin 2016 Rome IV C5 unspecified functional bowel disorder)
```

## Citation

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

## Worked example

### All seven required flags

Given: `bowel_symptoms_not_attributable_to_organic_etiology=true, does_not_meet_criteria_for_functional_bloating_distension=true, does_not_meet_criteria_for_functional_constipation=true, does_not_meet_criteria_for_functional_diarrhea=true, does_not_meet_criteria_for_ibs=true, fulfilled_last_3_months=true, onset_at_least_6_months=true`

1. Bowel symptoms not attributable to an organic etiology is true
2. Does not meet criteria for IBS is true
3. Does not meet criteria for functional constipation is true
4. Does not meet criteria for functional diarrhea is true
5. Does not meet criteria for functional bloating/distension is true
6. Criteria fulfilled for the last 3 months and onset at least 6 months prior are true
7. rome_iv_unspecified_bowel is true


### Six required flags while IBS criteria are met

Given: `bowel_symptoms_not_attributable_to_organic_etiology=true, does_not_meet_criteria_for_functional_bloating_distension=true, does_not_meet_criteria_for_functional_constipation=true, does_not_meet_criteria_for_functional_diarrhea=true, does_not_meet_criteria_for_ibs=false, fulfilled_last_3_months=true, onset_at_least_6_months=true`

1. Six required flags hold
2. Does not meet criteria for IBS is false (meets IBS, so not C5)
3. rome_iv_unspecified_bowel is false


## Also searched as

- Rome IV unspecified functional bowel
- Rome IV C5
- Mearin 2016 unspecified bowel
- unspecified functional bowel disorder
- functional bowel disorder unspecified
- Rome IV unspecified bowel
- C5 unspecified bowel
- Mearin C5
- Rome IV residual bowel

## Parameters

- `bowel_symptoms_not_attributable_to_organic_etiology` (boolean, required): Bowel symptoms not attributable to an organic etiology, as assigned (Mearin 2016 Rome IV C5). true or false as assigned by the caller. magent does not examine the patient.
- `does_not_meet_criteria_for_ibs` (boolean, required): Does not meet criteria for IBS, as assigned by the caller (Mearin 2016 C5). true or false. magent does not re-score the IBS box.
- `does_not_meet_criteria_for_functional_constipation` (boolean, required): Does not meet criteria for functional constipation, as assigned by the caller (Mearin 2016 C5). true or false. magent does not re-score functional constipation.
- `does_not_meet_criteria_for_functional_diarrhea` (boolean, required): Does not meet criteria for functional diarrhea, as assigned by the caller (Mearin 2016 C5). true or false. magent does not re-score functional diarrhea.
- `does_not_meet_criteria_for_functional_bloating_distension` (boolean, required): Does not meet criteria for functional abdominal bloating/distension, as assigned by the caller (Mearin 2016 C5). true or false. magent does not re-score bloating or distension.
- `fulfilled_last_3_months` (boolean, required): Criteria fulfilled for the last 3 months, as assigned (Mearin 2016 C5). 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 (Mearin 2016 C5). 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_unspecified_bowel`
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": [
    {
      "bowel_symptoms_not_attributable_to_organic_etiology": "true",
      "does_not_meet_criteria_for_functional_bloating_distension": "true",
      "does_not_meet_criteria_for_functional_constipation": "true",
      "does_not_meet_criteria_for_functional_diarrhea": "true",
      "does_not_meet_criteria_for_ibs": "true",
      "fulfilled_last_3_months": "true",
      "onset_at_least_6_months": "true"
    },
    {
      "bowel_symptoms_not_attributable_to_organic_etiology": "true",
      "does_not_meet_criteria_for_functional_bloating_distension": "true",
      "does_not_meet_criteria_for_functional_constipation": "true",
      "does_not_meet_criteria_for_functional_diarrhea": "true",
      "does_not_meet_criteria_for_ibs": "true",
      "fulfilled_last_3_months": "true",
      "onset_at_least_6_months": "true"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/rome_iv_unspecified_bowel",
  "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_unspecified_bowel",
      "formula_expression": "rome_iv_unspecified_bowel iff bowel_symptoms_not_attributable_to_organic_etiology and does_not_meet_criteria_for_ibs and does_not_meet_criteria_for_functional_constipation and does_not_meet_criteria_for_functional_diarrhea and does_not_meet_criteria_for_functional_bloating_distension and fulfilled_last_3_months and onset_at_least_6_months (Mearin 2016 Rome IV C5 unspecified functional bowel disorder)",
      "criteria": [
        {
          "factor": "bowel_symptoms_not_attributable_to_organic_etiology",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_ibs",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_functional_constipation",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_functional_diarrhea",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_functional_bloating_distension",
          "met": true
        },
        {
          "factor": "fulfilled_last_3_months",
          "met": true
        },
        {
          "factor": "onset_at_least_6_months",
          "met": true
        }
      ],
      "rome_iv_unspecified_bowel": 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_unspecified_bowel",
      "formula_expression": "rome_iv_unspecified_bowel iff bowel_symptoms_not_attributable_to_organic_etiology and does_not_meet_criteria_for_ibs and does_not_meet_criteria_for_functional_constipation and does_not_meet_criteria_for_functional_diarrhea and does_not_meet_criteria_for_functional_bloating_distension and fulfilled_last_3_months and onset_at_least_6_months (Mearin 2016 Rome IV C5 unspecified functional bowel disorder)",
      "criteria": [
        {
          "factor": "bowel_symptoms_not_attributable_to_organic_etiology",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_ibs",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_functional_constipation",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_functional_diarrhea",
          "met": true
        },
        {
          "factor": "does_not_meet_criteria_for_functional_bloating_distension",
          "met": true
        },
        {
          "factor": "fulfilled_last_3_months",
          "met": true
        },
        {
          "factor": "onset_at_least_6_months",
          "met": true
        }
      ],
      "rome_iv_unspecified_bowel": true
    }
  ]
}
```

## Response fields

- `formula` (string): rome_iv_unspecified_bowel
- `formula_expression` (string): Mearin 2016 Rome IV C5: bowel symptoms not attributable to an organic etiology, does not meet criteria for IBS, functional constipation, functional diarrhea, or functional bloating/distension, last-3-months criteria, and 6-month onset
- `rome_iv_unspecified_bowel` (boolean): true only when all seven required flags hold. Residual C5 only. Not a diagnosis.
- `criteria` (array): Per-factor rows with factor and met for the seven required flags
- `citation` (object): Mearin 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": "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_unspecified_bowel",
  "formula_expression": "rome_iv_unspecified_bowel iff bowel_symptoms_not_attributable_to_organic_etiology and does_not_meet_criteria_for_ibs and does_not_meet_criteria_for_functional_constipation and does_not_meet_criteria_for_functional_diarrhea and does_not_meet_criteria_for_functional_bloating_distension and fulfilled_last_3_months and onset_at_least_6_months (Mearin 2016 Rome IV C5 unspecified functional bowel disorder)",
  "criteria": [
    {
      "factor": "bowel_symptoms_not_attributable_to_organic_etiology",
      "met": true
    },
    {
      "factor": "does_not_meet_criteria_for_ibs",
      "met": true
    },
    {
      "factor": "does_not_meet_criteria_for_functional_constipation",
      "met": true
    },
    {
      "factor": "does_not_meet_criteria_for_functional_diarrhea",
      "met": true
    },
    {
      "factor": "does_not_meet_criteria_for_functional_bloating_distension",
      "met": true
    },
    {
      "factor": "fulfilled_last_3_months",
      "met": true
    },
    {
      "factor": "onset_at_least_6_months",
      "met": true
    }
  ],
  "rome_iv_unspecified_bowel": true
}
```

## Errors

- HTTP 400 `invalid_rome_iv_unspecified_bowel`: Rome IV unspecified functional bowel needs the Mearin 2016 C5 bowel-symptom and exclusion 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

- [Rome IV IBS](https://magentlab.com/docs/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).
- [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.