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Functional bowel disorders / General Approach to Functional Bowel Disorders
General Approach to Functional Bowel Disorders
The Rome diagnostic criteria of the functional bowel disorders are used widely, both in research and practice. Recently, a new committee consensus approach, including criticism from multinational expert reviewers, was used to revise the Rome II diagnostic criteria and update diagnosis and treatment recommendations, based on research results (results were released at the end of 2006). The changes affect all functional pathologies, but they are specially important on functional bowel disorders because they affect directly the classification of IBS.
| The main changes instituted from Rome II to Rome III criteria are: | |
| 1. | Introduction of a frequency threshold of symptoms needed to meet criteria (e.g., =3 days per month in the last 3 months). |
| 2. | Duration of symptoms ( onset>=6 months ago ) before one can make a firm diagnosis. |
| 3. | Refining the subtyping of IBS(1). |
Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features(1).
Functional bowel disorders (FBD), with symptoms ascribable to the mid or lower gastrointestinal tract, include: irritable bowel syndrome (IBS), functional abdominal bloating, functional constipation, functional diarrhoea, and unspecified functional bowel disorder(1). The diagnosis always presumes the absence of a structural or biochemical explanation for the symptoms(1,2).
IBS, functional abdominal bloating, functional constipation, and functional diarrhoea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs(1).
As these entities are identified by symptoms and patient care is highly individualized, a symptom-based classification has great importance, particularly when used in clinical trials(2)
1. Thompson W. G., Longstreth G. F., Drossman D. A. Functional bowel disorders and functional abdominal pain. Gut 1999; 45 Supplement II: II43-II47.
2. Longstreth G.F., Thompson W.G., Chey W.D. Functional bowel disorders. Gastroenterology 2006; 130: 1480-1491.