The "Rome Process" is an international effort to define and categorize the functional gastrointestinal disorders (of unknown cause) such as Irritable bowel syndrome and Functional dyspepsia. This approach represents a substantial change in thinking given that doctors have usually relied on basic science and palpable “evidence” to diagnose all kinds of ailments. More than half of gut disorders encountered by physicians are functional (i.e. disorders of gut function) and there is no structural or biochemical explanation for them, so it was necessary to develop alternate methods to identify them. This process is akin to that followed by psychiatrists to categorize and diagnose psychiatric entities, which culminated in the DSM-IV criteria. These should not be “diagnoses of exclusion"; they demand a more positive approach. For alternative meanings see definition (disambiguation) A definition may be a statement of the essential properties of a certain thing, or a statement of equivalence between a term and that terms meaning. ... For Wikipedias categorization projects, see Wikipedia:Categorization. ... In medicine, the term functional bowel disorder refers to a group of bowel disorders which are characterised by chronic abdominal complaints without a structural or biochemical cause that could explain symptoms. ... Dyspepsia is a constant pain in the stomach. ... Pure science, also called basic science, is the exact science of the development of scientific theories, without consideration of their application. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. ... Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... This article or section does not cite its references or sources. ... Psychiatry is a medical specialty dealing with the prevention, assessment, diagnosis, treatment, and rehabilitation of mental illness – both in itself and in bodily illness (psychiatry in medicine) – such as clinical depression, bipolar disorder, schizophrenia and anxiety disorders. ... The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ... Criterion DVD Series The Criterion Collection, a continuing series of important classic and contemporary films, is dedicated to gathering the greatest films from around the world and publishing them in editions that offer the highest technical quality and award-winning, original supplements. ...

History

There were systematic approaches that attempted to classify the then hazy area of functional gastrointestinal disorders from as early as 1962 when Chaudhary and Truelove published a retrospective review of IBS patients at Oxford, England. Later on, the "Manning Criteria" for irritable bowel syndrome were derived from a paper published in 1978 by Manning and colleagues. This seminal classification started a new era and, from then on, scientific work on functional gastrointestinal disorders proceeded with increased enthusiasm. 1962 (MCMLXII) was a common year starting on Monday (the link is to a full 1962 calendar). ... Oxford is a city and local government district in Oxfordshire, England, with a population of 134,248 (2001 census). ... 1978 (MCMLXXVIII) was a common year starting on Sunday. ...

The Rome criteria have been evolving from the first set of criteria issued in 1989 (The Rome Guidelines for IBS) through the Rome Classification System for FGIDs (1990), or Rome-1, the Rome I Criteria for IBS (1992) and the FGIDs (1994), the Rome II Criteria for IBS (1999) and the FGIDs (1999) to the recent Rome III Criteria (2006). "Rome II" and "Rome III" incoporated pediatric criteria to the consensus. 1989 (MCMLXXXIX) was a common year starting on Sunday of the Gregorian calendar. ... In medicine (gastroenterology), irritable bowel syndrome (IBS) is a group of functional bowel disorders which are fairly common and make up 20–50% of visits to a specialist. ... This article is about the year. ... 1992 (MCMXCII) was a leap year starting on Wednesday. ... 1994 (MCMXCIV) was a common year starting on Saturday of the Gregorian calendar, and was designated as the International Year of the Family and the International Year of the Sport and the Olympic Ideal by United Nations. ... 1999 (MCMXCIX) was a common year starting on Friday, and was designated the International Year of Older Persons by the United Nations. ... 2006 (MMVI) is a common year starting on Sunday of the Gregorian calendar. ... Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that deals with the medical care of infants and children. ...

Process

The Rome criteria are achieved and finally issued through a consensual process, using the Delphi method (or Delphi Technique). The effort is organised by the Rome Coordinating Committee. This process typically takes many months of work by investigators, organized into committees. The committees work by mail and telephone conferences until the final, defining meeting, which (logically) takes place in Rome, Italy. The Rome III effort encompassed 87 participants from 18 countries in 14 committees. Members were added from countries outside the more industrialized Western nations; this time there were members from China, Brazil, Chile, Venezuela, Hungary, and Romania. Additional working teams were created to work on issues like: gender, society, patient, and social issues; and pharmacology and pharmacokinetics. Two committees (neonate/toddler and child/adolescent), rather than one, served the pediatrics FGIDs. Consensus has two common meanings. ... // The Delphi method and consensus building The Delphi method is a technique aimed at building an agreement, or consensus about an opinion or view, without necessarily having people meet face to face, such as through surveys, questionaires, emails etc. ... The Roman Colosseum Rome (Italian and Latin Roma) is the capital city of Italy, and of its Lazio region. ... The word gender describes the state of being male, female, or neither. ... Human relationships within an ethnically diverse society. ... A patient is any person who receives medical attention, care, or treatment [1]. A patient is often ill or injured and is being treated by, or in need of treatment by, a physician or other medical professional. ... // The Unobservable Although the term social is a crucial category in social science and often used in public discourse, its meaning is often vague, suggesting that it is a fuzzy concept. ... Pharmacology (in Greek: pharmacon (φάρμακον) meaning drug, and logos (λόγος) meaning science) is the study of how chemical substances interact with living systems. ... Pharmacokinetics is a branch of pharmacology dedicated to the study of the time course of substances and their relationship with an organism or system. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... A male toddler A female toddler A toddler is a child between the ages of one and three years old, although some may consider a toddler to be between two and five. ... It has been suggested that Childhood be merged into this article or section. ... A separate article is about the punk band called The Adolescents. ... Pediatrics (also spelled paediatrics) is the branch of medicine that deals with the medical care of infants, children, and adolescents (from newborn to age 18-21). ...

Classification

Adult patients

In the Rome III classification, the Functional GI Disorders (FGIDs) are classified into six major domains for adults:

• Esophageal (category A)
• Gastroduodenal (category B)
• Bowel (category C)
• Functional Abdominal Pain Syndrome (category D)
• Biliary (category E)
• Anorectal (category F)

The functional bowel disorders (category C) include: Irritable bowel syndrome (C1); Functional bloating (C2); Functional constipation (C3); Functional diarrhea (C4) The esophagus (also spelled oesophagus/œsophagus), or gullet is the muscular tube in vertebrates through which ingested food passes from the mouth area to the stomach. ... The intestine is the portion of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine. ... Chronic functional abdominal pain (CFAP) is the ongoing presence of abdominal pain for which there is no physical explanation. ... X-Ray of the bile duct during a laprascopic cholecystectomy A bile duct is any of a number of long tube-like structures that carry bile. ... Anorectal is a class of medical conditions. ... Bloating is any abnormal general swelling, or increase in diameter of the abdominal area. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to eliminate; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Diarrhea or diarrhoea (see spelling differences) is a condition in which the sufferer has frequent watery, loose bowel movements (from the ancient Greek word διαρροή = leakage; lit. ...

Irritable bowel syndrome (C1) is more specifically defined as pain associated with change in bowel habit, which is different from functional diarrhea.

Pediatric patients

The pediatric domains are classified first by age range and then by symptom pattern or area of symptom. Each domain contains several disorders, each with relatively specific clinical features.

• Neonate/Toddler (category G)
  • G1. Infant regurgitation
  • G2. Infant rumination syndrome
  • G3. Cyclic vomiting syndrome
  • G4. Infant colic
  • G5. Functional diarrhea
  • G6. Infant dyschezia
  • G7. Functional constipation

• Child/Adolescent (category H)
  • H1. Vomiting and aerophagia: H1a. Adolescent rumination syndrome; H1b. Cyclic vomiting syndrome; H1c. Aerophagia
  • H2. Abdominal pain–related FGIDs: H2a. Functional dyspepsia; H2b. Irritable bowel syndrome; H2c. Abdominal migraine; H2d. Childhood functional abdominal pain
  • H3. Constipation and incontinence: H3a. Functional constipation; H3b. Nonretentive fecal incontinence

A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... A male toddler A female toddler A toddler is a child between the ages of one and three years old, although some may consider a toddler to be between two and five. ... Regurgitation is the passive flow of stomach contents back into the esophagus and mouth. ... Rumination may mean a calm lengthy intent consideration, but can have several meanings, which need to be adressed separately Cud chewing of Cows and other Ruminants Negative cyclic thinking, persistent and recurrent worrying or brooding; see Clinical depression, Obsessive-compulsive disorder Rumination (eating disorder) This is a disambiguation page &#8212... Repetition is the occurrence of an event which has occurred before. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... Colic may refer to: Baby colic – a condition, usually in infants, characterized by incessant crying. ... Diarrhea or diarrhoea (see spelling differences) is a condition in which the sufferer has frequent watery, loose bowel movements (from the ancient Greek word διαρροή = leakage; lit. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to eliminate; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... It has been suggested that Childhood be merged into this article or section. ... A separate article is about the punk band called The Adolescents. ... Aerophagia (var. ... Look up incontinence in Wiktionary, the free dictionary. ... Fecal incontinence is the inability to control ones bowels. ...

Sources

• Gastroenterology (Journal) 2006;130:1552–1556
• The Rome Criteria