The Rome IV: Irritable bowel syndrome - A functional disorder

Best Pract Res Clin Gastroenterol. 2019 Jun-Aug:40-41:101634. doi: 10.1016/j.bpg.2019.101634. Epub 2019 Jul 18.


Functional gastrointestinal disorders are the most common disorders encountered in the clinical gastroenterology setting. Over the years the Rome process has generated consensus definitions of functional gastrointestinal disorders, and given diagnostic criteria, based on various symptom patterns, that have evolved over the years. The latest Rome IV consensus was presented in May 2016. This summary points out some of the important changes made from the Rome III 2006 consensus including evaluation of symptoms from the stand-point of basal normative values and disorders of gut-brain interaction, as well as additions of the importance of the microflora. However, we are all aware of the fact that there are limitations, and the Rome consensus does not pick up all patients with functional gastrointestinal disorders. Out of those that seek medical help for their functional gastrointestinal symptoms additional outlines of disease have to be considered and judgements made on the patients' actual symptoms, or rather presentation of their symptoms. The Rome IV consensus is a robust standard for a clinical and research approach to functional gastrointestinal disorders, but might be improved by use of exclusion criteria and additional biochemical biomarkers in order to accurately diagnose those patients who may achieve relief by an extended treatment approach in the clinical setting of gastroenterology. A biopsychosocial approach to the patient is recommended to improve compliance and optimize treatment and outcomes.

Keywords: Abdominal pain; Bloating; Constipation; Defecation; Diarrhoea; Stool.

Publication types

  • Review

MeSH terms

  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / pathology
  • Humans
  • Irritable Bowel Syndrome / physiopathology*