Functional Bowel Disorders

George F. Longstreth, W. Grant Thompson, William D. Chey, Lesley A. Houghton, Fermin Mearin, Robin C. Spiller

Research output: Contribution to journalArticle

3411 Scopus citations

Abstract

Employing a consensus approach, our working team critically considered the available evidence and multinational expert criticism, revised the Rome II diagnostic criteria for the functional bowel disorders, and updated diagnosis and treatment recommendations. Diagnosis of a functional bowel disorder (FBD) requires characteristic symptoms during the last 3 months and onset ≥6 months ago. Alarm symptoms suggest the possibility of structural disease, but do not necessarily negate a diagnosis of an FBD. Irritable bowel syndrome (IBS), functional bloating, functional constipation, and functional diarrhea are best identified by symptom-based approaches. Subtyping of IBS is controversial, and we suggest it be based on stool form, which can be aided by use of the Bristol Stool Form Scale. Diagnostic testing should be guided by the patient's age, primary symptom characteristics, and other clinical and laboratory features. Treatment of FBDs is based on an individualized evaluation, explanation, and reassurance. Alterations in diet, drug treatment aimed at predominant symptoms, and psychotherapy may be beneficial.

Original languageEnglish (US)
Pages (from-to)1480-1491
Number of pages12
JournalGastroenterology
Volume130
Issue number5
DOIs
StatePublished - May 2006

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Longstreth, G. F., Thompson, W. G., Chey, W. D., Houghton, L. A., Mearin, F., & Spiller, R. C. (2006). Functional Bowel Disorders. Gastroenterology, 130(5), 1480-1491. https://doi.org/10.1053/j.gastro.2005.11.061