Department of Medical Sciences, Gastroenterology and Hepatology, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Gastroenterology and Hepatology, Uppsala University, Uppsala, Sweden.
Best Pract Res Clin Gastroenterol. 2019 Jun-Aug;40-41:101634. doi: 10.1016/j.bpg.2019.101634. Epub 2019 Jul 18.
Functional gastrointestinal disorders are the most common disorders encountered in the clinical gastroenterology setting. Over the years the Rome process has generated consensus definitions of functional gastrointestinal disorders, and given diagnostic criteria, based on various symptom patterns, that have evolved over the years. The latest Rome IV consensus was presented in May 2016. This summary points out some of the important changes made from the Rome III 2006 consensus including evaluation of symptoms from the stand-point of basal normative values and disorders of gut-brain interaction, as well as additions of the importance of the microflora. However, we are all aware of the fact that there are limitations, and the Rome consensus does not pick up all patients with functional gastrointestinal disorders. Out of those that seek medical help for their functional gastrointestinal symptoms additional outlines of disease have to be considered and judgements made on the patients' actual symptoms, or rather presentation of their symptoms. The Rome IV consensus is a robust standard for a clinical and research approach to functional gastrointestinal disorders, but might be improved by use of exclusion criteria and additional biochemical biomarkers in order to accurately diagnose those patients who may achieve relief by an extended treatment approach in the clinical setting of gastroenterology. A biopsychosocial approach to the patient is recommended to improve compliance and optimize treatment and outcomes.
功能性胃肠病是临床胃肠病学中最常见的疾病。多年来，罗马进程已经为功能性胃肠病生成了共识定义，并给出了基于各种症状模式的诊断标准，这些标准随着时间的推移而不断发展。最新的罗马 IV 共识于 2016 年 5 月提出。本摘要指出了一些重要的变化，这些变化来自于 2006 年的罗马 III 共识，包括从基础正常值的角度评估症状以及肠道-大脑相互作用障碍，以及微生物群的重要性的增加。然而，我们都知道存在局限性，罗马共识并没有囊括所有功能性胃肠病患者。在那些因功能性胃肠症状寻求医疗帮助的患者中，还需要考虑其他疾病的概述，并根据患者的实际症状或症状表现做出判断。罗马 IV 共识是功能性胃肠病临床和研究方法的一个有力标准，但可以通过使用排除标准和额外的生化生物标志物来改进，以便在胃肠病学的临床环境中准确诊断那些可能通过扩展治疗方法获得缓解的患者。建议采用生物心理社会方法来治疗患者，以提高依从性，优化治疗效果。
