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Abstract
The publication in the April, 2006 issue of
Gastroenterology of Rome III has made available to the
scientific world an enhanced and updated version of the
Rome criteria and related information on the functional GI
disorders. It is expected that the criteria will be adopted and
used by physicians, pharmaceuticals and regulatory
agencies worldwide, just as the previous Rome II became
the standard for clinical practice and research. In this issue
of J Gastrointestin Liver Dis, these Guidelines, the Rome III,
are presented. Also included are some of the differences
between Rome II and Rome III criteria as well as the rationale
for publishing this new version.
Key words
Functional gastrointestinal disorders - Rome III
Introduction
Functional gastrointestinal disorders (FGID) represent
a common and important class of disorders within
gastroenterology. The large number of patients suffering
from the FGIDs, as well as the high frequency of functional
GI symptoms in general within the population, the health
care burden produced by the use of medical services and
medications for these conditions, and its eventual outcome
in terms of work absenteeism are well known (1-4).
Quite possibly, increased awareness of the FGIDs may
have resulted from the activity of the Rome working group,
later called the Rome Foundation. This group introduced a
standard for the classification and diagnosis of the FGID,
the Rome criteria. A series of documents in the early 1990s
published in Gastroenterology International was eventually
J Gastrointestin Liver Dis
September 2006 Vol.15 No.3, 237-241
Address for correspondence: Douglas A Drossman
Division of Gastroenterol.Hepatol.
UNC Center for Functional GI
and Motility Disorders
Chapel Hill, NC, USA
238
239
240
syndrome. These are similar to dysmotility-like and ulcerlike dyspepsia of Rome II. However, they are now defined
by a complex of symptom features with physiological support
rather than being based on the predominant symptom of
epigastric discomfort or pain respectively.
b. More restrictive criteria for functional disorders of
the gallbladder and sphincter of Oddi. There are more
defining features and exclusions required for symptom-based
diagnosis of these conditions. In doing so, we have reduced
the patient population who would then receive invasive
studies like endoscopic retrograde cholangiopancreatography (ERCP) and manometry to confirm the diagnosis and
be treated.
c. Revision of IBS subtypes criteria. The committees are
recommending that diarrhea, constipation and mixed
subtypes be based on a simple classification related to stool
consistency. However, the bowel sub-typing used in Rome
II for diarrhea-predominant IBS (IBS-D) and constipationpredominant IBS (IBS-C) is still acceptable.
Conclusion
It is expected that the new Rome III criteria will rapidly
gain acceptance and use as occurred with Rome II, and
become the new standard for diagnosis and care of the
FGIDs. Of course, papers and studies with Rome II criteria
will continue to be issued. There is a need to validate the
new terms in non-Anglo-Saxon languages like the Latin
languages, especially the postprandial distress syndrome.
The members of the Rome Foundation hope that the
Rome criteria will enhance the development of our knowledge
on the FGID.
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