Rome Criteria
In the past, FGDs were considered to be diagnoses of exclusion, meaning that they could only be diagnosed after organic (identifiable) disease was ruled out. However, back in 1988, a group of researchers and healthcare providers met to devise strict criteria for the diagnosis of the various FGDs. These criteria are now known as the Rome Criteria. The fourth revision came out in 2016.
Functional Gastrointestinal Disorders
Here is a comprehensive list of FGDs as delineated by the Rome III criteria:
Functional Esophageal Disorders
Functional heartburn Functional chest pain of presumed esophageal origin Functional dysphagia Globus
Functional Gastroduodenal Disorders
Functional dyspepsia (includes postprandial distress syndrome and epigastric pain syndrome Aerophagia Unspecified excessive belching Chronic idiopathic nausea Functional vomiting Cyclic vomiting syndrome Rumination syndrome in adults
Functional Bowel Disorders
Irritable bowel syndrome (IBS) Functional constipation Functional diarrhea Unspecified functional bowel disorder
Functional Abdominal Pain Syndrome
Functional abdominal pain (FAP)
Functional Gallbladder and Sphincter of Oddi Disorders
Functional gallbladder disorder Functional biliary Sphincter of Oddi disorder Functional pancreatic Sphincter of Oddi disorder
Functional Anorectal Disorders
Functional fecal incontinence Functional Anorectal Pain (includes chronic proctalgia, Levator ani syndrome), unspecified functional anorectal pain, and proctalgia fugax) Functional Defecation Disorders (includes dyssynergic defecation and inadequate defecatory propulsion)
Childhood Functional GI Disorders: Infant/Toddler
Infant regurgitationInfant rumination syndromeCyclic vomiting syndromeInfant colicFunctional diarrheaInfant dyscheziaFunctional constipation
Childhood Functional GI Disorders: Child/Adolescent
Vomiting and Aerophagia: adolescent rumination syndrome, cyclic vomiting syndrome, and aerophagiaAbdominal Pain-Related Functional GI Disorders: functional dyspepsia, IBS, abdominal migraine, childhood functional abdominal pain, and childhood functional abdominal pain syndromeConstipation and Incontinence: functional constipation and nonretentive fecal incontinence
Diagnosis of Functional Gastrointestinal Disorders
Although the Rome criteria allow the diagnosis of FGDs to be symptom-based, your healthcare provider may still want to run some standard diagnostic tests to rule out other diseases or to look for structural problems that are resulting in your symptoms.
Treatment of Functional Gastrointestinal Disorders
Although no visible signs of disease or structural problems are identified as causing the symptoms of FGDs, this does not mean that these disorders are not real, nor does it mean that they are not treatable. If you suspect you have or have been diagnosed with an FGD, it will be essential to work with your healthcare provider on a working treatment plan. Treatment options may include:
MedicationDietary changesBiofeedbackPhysical therapyStress managementPsychotherapy
