Gastroenterology

Gastroenterology

Volume 130, Issue 5, April 2006, Pages 1377-1390
Gastroenterology

Introduction
The Functional Gastrointestinal Disorders and the Rome III Process

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The Rome III Classification System FGIDs

The 28 adult and 17 pediatric FGIDs are presented in Table 1. These are symptom-based diagnostic criteria that are not explained by other pathologically based disorders. In recent years, however, histological findings have been identified that blur the distinction between “functional” and “organic.”3, 10, 36 The FGIDs are better categorized by their motor and sensory physiology and CNS relationships that produce disorders of GI functioning; as such, there can be clinical overlap of FGIDs with

Scientific Observations on the Pathophysiology of Functional GI Disorders

Using Figure 1 as a template, the following is a more detailed description of these associations.

An Approach to the Care of Patients With Functional GI Disorders

This section provides general care guidelines for patients with FGIDs. Further information can be found elsewhere.91, 92, 93, 94, 95

The Rome Committees and Criteria Development

Beginning about 15–20 years ago, and with greater recognition of the FGIDs, the academic environment was receptive to a classification system that could be used for research and clinical care. At this time, the Rome working teams began, and have since served as the nidus to modify and update information on these disorders. With no prior standards or evidence from research, the groups developed criteria by consensus (via the Delphi Approach).99, 100 Over time and with acquisition of new data,

Concluding Comments

It is with great anticipation that we introduce this issue of Gastroenterology: Rome III, The Functional Gastrointestinal Disorders. We hope that the information will help the reader gain a better understanding of these disorders and help clinicians in the diagnosis and care of our patients. This work is the culmination of a 5-year effort of 87 internationally recognized investigators representing 18 countries. As we look back on the process, the information we have obtained is comprehensive,

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References (115)

  • F. Azpiroz et al.

    Anorectal functional testingreview of collective experience

    Am J Gastroenterol

    (2002)
  • H.P. Parkman et al.

    American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis

    Gastroenterology

    (2004)
  • D.A. Drossman et al.

    Cognitive-behavioral therapy vs. education and desipramine vs. placebo for moderate to severe functional bowel disorders

    Gastroenterology

    (2003)
  • F. Creed et al.

    The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome

    Gastroenterology

    (2003)
  • V.S. Chadwick et al.

    Activation of the mucosal immune system in irritable bowel syndrome

    Gastroenterology

    (2002)
  • M. Camilleri et al.

    Serotonin-transporter polymorphism pharmacogenetics in diarrhea-predominant irritable bowel syndrome

    Gastroenterology

    (2002)
  • G. Holtmann et al.

    G-protein beta3 subunit 825 CC genotype is associated with unexplained (functional) dyspepsia

    Gastroenterology

    (2004)
  • G.R. Locke et al.

    Familial association in adults with functional gastrointestinal disorders

    Mayo Clin Proc

    (2000)
  • R.L. Levy et al.

    Irritable bowel syndrome in twinsheredity and social learning both contribute to etiology

    Gastroenterology

    (2001)
  • R.L. Levy et al.

    Intergenerational transmission of gastrointestinal illness behavior

    Am J Gastroenterol

    (2000)
  • R.L. Levy et al.

    Costs of care for irritable bowel syndrome patients in a health maintenance organization

    Am J Gastoenterol

    (2001)
  • E.M.M. Quigley et al.

    AGA technical review on nausea and vomiting

    Gastroenterol

    (2001)
  • G.R. Locke et al.

    AGA technical review on constipation

    Gastroenterology

    (2000)
  • D.A. Drossman et al.

    AGA technical review on irritable bowel syndrome

    Gastroenterology

    (2002)
  • E.A. Mayer et al.

    Basic and clinical aspects of visceral hyperalgesia

    Gastroenterology

    (1994)
  • J. Munakata et al.

    Repetitive sigmoid stimulation induces rectal hyperalgesia in patients with irritable bowel syndrome

    Gastroenterology

    (1997)
  • G. Barbara et al.

    Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome

    Gastroenterology

    (2004)
  • S.P. Dunlop et al.

    Abnormalities of 5-hydroxytryptamine metabolism in irritable bowel syndrome

    Clin Gastroenterol Hepatol

    (2005)
  • R.C. Spiller

    Post infectious irritable bowel syndrome

    Gastroenterology

    (2003)
  • S.P. Dunlop et al.

    Relative importance of enterochromaffin cell hyperplasia, anxiety and depression in post-infectious IBS

    Gastroenterology

    (2003)
  • R. Stam et al.

    Long-lasting changes in central nervous system responsivity to colonic distention after stress in rats

    Gastroenterology

    (2002)
  • F. Mearin et al.

    Dyspepsia after a Salmonella gastroenteritis outbreakone-year follow-up cohort study

    Gastroenterology

    (2005)
  • M. Pimentel et al.

    Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome

    Am J Gastroenterol

    (2000)
  • L. O’Mahony et al.

    Lactobacillus and bifidobacterium in irritable bowel syndromesymptom responses and relationship to cytokine profiles

    Gastroenterol

    (2005)
  • R.M. Valori et al.

    Effects of different types of stress and or “prokinetic” drugs on the control of the fasting motor complex in humans

    Gastroenterology

    (1986)
  • C.D. Murray et al.

    Effect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome

    Gastroenterology

    (2004)
  • T.G. Dinan et al.

    Hypothalamic-pituitary-gut axis dysregulation in irritable bowel syndromeplasma cytokines as a potential biomarker

    Gastroenterology

    (2006)
  • A.R. Hobson et al.

    Real-time imaging of human cortical activity evoked by painful esophageal stimulation

    Gastroenterology

    (2005)
  • L. Yaguez et al.

    Brain response to visceral aversive conditioninga functional magnetic resonance imaging study 1

    Gastroenterology

    (2005)
  • M.K. Kern et al.

    Cerebral cortical registration of subliminal visceral stimulation

    Gastroenterology

    (2002)
  • H. Mertz et al.

    Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention

    Gastroenterolgy

    (2000)
  • D.A. Drossman et al.

    Alterations of brain activity associated with resolution of emotional distress and pain in a case of severe IBS

    Gastroenterology

    (2003)
  • L. Chang et al.

    Brain responses to visceral and somatic stimuli in patients with irritable bowel syndrome with and without fibromyalgia

    Am J Gastroenterol

    (2003)
  • G.N. Verne et al.

    Central representation of cutaneous and visceral pain in irritable bowel syndrome

    Gastroenterology

    (2001)
  • J.M. Lackner et al.

    Cognitive therapy for irritable bowel syndrome is associated with reduced limbic activity, GI symptoms, and anxiety

    Behav Res Ther

    (2005)
  • D.A. Drossman

    Psychosocial and psychophysiologic mechanisms in GI Illness

  • M.W. Russo et al.

    A national survey of practice patterns of gastroenterologists with comparison to the past two decades

    J Clin Gastroenterol

    (1999)
  • J. Christensen

    Heraclides or the physician

    Gastroenterol Int

    (1990)
  • M. Heitkemper et al.

    Women with irritable bowel syndromedifferences in patients’ and physicians’ perceptions

    Gastroenterol Nurs

    (2002)
  • G.L. Engel

    The need for a new medical modela challenge for biomedicine

    Science

    (1977)
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