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Rome Foundation Clinical Diagnostic Criteria for Disorders of Gut-Brain Interaction (DGBI).

D. Drossman,J. Tack

Published 2021 in Gastroenterology

ABSTRACT

The Rome criteria, which define Disorders of Gut-Brain Interaction (DGBIs), are extensively applied in epidemiological research, pathophysiological studies, treatment trials, and clinical practice. The requirement for long periods of symptom presence and high symptom frequencies facilitated the use of the Rome criteria in epidemiology studies and treatment trials but has hampered clinical application when these requirements were not fulfilled. The Rome Foundation proposes a modification of the diagnostic criteria for clinical practice, where a DGBI diagnosis can still be made if 1) the nature of symptoms corresponds to those in the DGBI Rome IV diagnostic criteria, and 2) symptoms are bothersome (interfering with daily activities or requiring attention, causing worry or interference with quality of life). If this is the case, a lower frequency and a shorter duration (8 weeks or more) than those required for the Rome DGBI diagnostic threshold are allowed, provided that there is clinical confidence that other diagnoses have been sufficiently ruled out based on presentation and additional investigations as needed. Applying these criteria for clinical practice will allow the clinician to make a diagnosis, reduce unnecessary diagnostic studies and enhance the patient-provider relationship. Further research is needed to validate these recommendations.

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