Disorders of gut-brain interaction are a new challenge of our increasingly complex society, with worldwide...

The term disorders of gut-brain interaction (DGBIs) encompasses gastrointestinal disorders that globally affect more than one third of all people. The Rome IV criteria replaced the former term "functional gastrointestinal disorders." DGBIs can seriously challenge health and quality of life (QoL). A traditional but outdated approach differentiated "organic" vs "functional" disorders, seen by some as real vs psychiatric or undefined ones. This traditional distinction did not help patients whose health and QoL are seriously affected. DGBIs include motility disturbance; visceral hypersensitivity; altered mucosal and immune function; altered central nervous system processing, and more. Several DGBIs affect both children and adolescents. DGBIs are characterized by clusters of symptoms. Their pathophysiology relates to combinations of altered motility, visceral sensitivity, mucosal immune function, and more. Routine investigations find no structural abnormality that would easily explain the symptoms. Symptom-based criteria were developed to better understand patients where no mechanistic explanation was available for clinical practice and inclusion into clinical trials. To understand DGBIs and to find ways to treat them, these rigid mechanistic views fall short.