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7% vs 28.5%; P .001) or a gastroenterologist (26.3% vs 12.4%; P .001) for their IBS symptoms, were significantly more likely to have commenced a new treatment (73.0% vs 60.2%; P= .001), and cycled through significantly more treatments (P= .007), for their IBS compared with those with Rome III IBS. At follow-up evaluation, individuals with Rome IV IBS had more severe symptoms, which had a significantly greater impact on activities of daily living, were more likely to report continuous abdominal pain, and a higher proportion show