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Functional bowel disorders.

George F Longstreth1, W Grant Thompson, William D Chey

  • 1Kaiser Permanente Medical Care Program, San Diego, California 92120, USA. George.F.Longstreth@kp.org

Gastroenterology
|May 9, 2006
PubMed
Summary
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This study revises diagnostic criteria for functional bowel disorders (FBDs) and provides updated recommendations for diagnosis and treatment. Key FBDs like irritable bowel syndrome are best identified using symptom-based approaches and stool form for subtyping.

Area of Science:

  • Gastroenterology
  • Digestive Health
  • Clinical Practice Guidelines

Background:

  • Functional bowel disorders (FBDs) encompass a range of conditions affecting gut function.
  • Previous diagnostic criteria, such as Rome II, required critical review and updates.
  • Expert consensus is crucial for refining diagnostic and treatment strategies in gastroenterology.

Purpose of the Study:

  • To revise the Rome II diagnostic criteria for functional bowel disorders.
  • To update recommendations for the diagnosis and treatment of FBDs.
  • To provide a consensus-based approach for clinicians managing patients with FBDs.

Main Methods:

  • A consensus approach was employed, involving critical evaluation of existing evidence.
  • Multinational expert criticism was incorporated into the revision process.

Related Experiment Videos

  • Diagnostic criteria and treatment recommendations were updated based on collective expert input.

    • Main Results:

    • Revised diagnostic criteria for FBDs were established, requiring specific symptom duration and onset.
    • Symptom-based approaches are recommended for identifying irritable bowel syndrome, functional bloating, constipation, and diarrhea.
    • Stool form, potentially using the Bristol Stool Form Scale, is suggested for irritable bowel syndrome subtyping.

    Conclusions:

    • Functional bowel disorders require characteristic symptoms with specific temporal criteria for diagnosis.
    • Alarm symptoms warrant investigation but do not exclude an FBD diagnosis.
    • Individualized treatment plans involving explanation, reassurance, diet, pharmacotherapy, and psychotherapy are recommended for FBDs.