Functional bowel disorders and functional abdominal pain

The Rome diagnostic criteria for the functional bowel disorders and functio nal abdominal pain are used widely in research and practice. A committee co nsensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatme nt recommendations, based on research results. The terminology was clarifie d and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms f or at least 12 weeks during the preceding 12 months in the absence of a str uctural or biochemical explanation. The irritable bowel syndrome, functiona l abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FED lacks c riteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and la boratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relatio n to gut function and loss of daily activities, or unspecified FAP, which l acks criteria for the FAP syndrome. An organic cause for the pain must be e xcluded, but aspects of the patient's pain behavior are of primary importan ce. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be ben eficial, depending on the symptoms and psychological features.