Cited by 2,440Gastrointestinal motility and disordersPsychosomatic Disorders and Their TreatmentsGastroesophageal reflux and treatments

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Functional bowel disorders and functional abdominal pain

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Thompson, W G, Longstreth, G F, Drossman, D A, Heaton, K W, Irvine, E J, Müller-Lissner, S A·1999·Gut

DOI 10.1136/gut.45.2008.ii43PMC PMC1766683

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Abstract

The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient’s pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.

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Authors: Thompson, W. G., Longstreth, G. F., Drossman, D. A., Heaton, K. W., Irvine, E. J., & Müller-Lissner, S. A.
Affiliations: Kaiser Permanente (US)
Corresponding author: Thompson, W G
ORCID: Thompson, W G
Longstreth, G F
Drossman, D A
Venue: Gut
Publisher: BMJ
Published: 1999-09-01
Volume: 45
Issue: suppl 2
Pages: II43-II47
ISSN: 0017-5749 (ISSN-L)
1468-3288
DOI: 10.1136/gut.45.2008.ii43
PMC: PMC1766683
OpenAlex: W2166386674
Semantic Scholar: 9e1a4a0b207039b5d64277278fb3532bc6348472
Cited by: 2,440
References: 36
Citations by year: 2026: 11 · 2025: 20 · 2024: 18 · 2023: 38 · 2022: 28 · 2021: 47 · 2020: 36 · 2019: 30 · 2018: 47 · 2017: 43 · 2016: 64 · 2015: 77 · 2014: 81 · 2013: 92 · 2012: 123
FWCI: 64.06
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Gut (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
UNC Libraries
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
Keywords: functional bowel disorders, functional abdominal pain, irritable bowel syndrome, functional constipation, functional diarrhea, diagnostic criteria revision, treatment guidelines, pain behavior, dietary change, psychotherapy, pharmacotherapy
MeSH terms: Colonic Diseases, Functional, Constipation, Diarrhea, Gastrointestinal Diseases, Humans, Abdominal Pain

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