126:(or Delphi technique). The Rome Foundation process is an international effort to create scientific data to help in the diagnosis and treatment of functional gastrointestinal disorders, also known as disorders of gut-brain interaction. The Rome Diagnostic criteria are set forth by the Rome Foundation, an independent, not for profit 501(c)(3) organization.
70:(FGIDs). As a result, there were several key events which ultimately led to the current Rome Classification. In 1962, Chaudhary and Truelove published their study of IBS patients in Oxford, England. This was the first attempt to classify the new field of functional gastrointestinal disorders. Much of what they reported has persisted to the present day.
265:
classification to a symptom-based classification with additional classifications based upon organ regions (i.e. esophageal, gastroduodenal, bowel, biliary, anorectal). The current Rome IV classification is the culmination of the evolution of a series of iterations (Rome I, Rome II, and Rome III) with its inception as Rome I.
264:
The original Rome classification was first published in 1990 and has since been modified with each iteration to develop the subsequent classifications with Rome II, III and IV. Beginning with the original publication in 1990 and leading to Rome I, the classification moved from a physiologically based
104:
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 functional gastrointestinal disorders (1990), or Rome-1, the Rome I Criteria for IBS (1992) and the functional gastrointestinal disorders (1994),
81:
From 1980 to 1994, there were several epidemiological and clinical studies evaluating symptom prevalence and frequency in healthy subjects and IBS patients. Thompson, Drossman, Talley, Whitehead, and Kruis. In 1989, the first consensus-based diagnostic criteria for IBS were established. The following
244:
To address the severity and variability of clinical presentation, a
Multidimensional Clinical Profile (MDCP) system has been created that incorporates the diagnostic criteria with additional clinical, quality of life, psychosocial, and physiological (including biomarker) parameters to more precisely
138:
Over the last 25 years, the Rome organization has sought to legitimize and update the knowledge of functional GI disorders. This has been accomplished by bringing together scientists and clinicians from around the world to classify and critically appraise the science of gastrointestinal function and
207:
By the mid-1990s, the concept of FGID classification and the use of diagnostic criteria was promoted due to the US Food and Drug
Administration (FDA) recommended the use of the IBS criteria for selection into pharmaceutical studies, and the pharmaceutical companies took interest in supporting the
109:
criteria to the consensus. The Rome IV update was published 10 years later in May 2016. This covers epidemiology, pathophysiology, psychosocial and clinical features, and diagnostic evaluation and treatment recommendations for 33 adult and 17 pediatric functional gastrointestinal disorders.
979:
Drossman DA. The Rome IV Committees, editor. Functional
Gastrointestinal Disorders and the Rome IV process. In: Drossman DA, Chang L, Chey WD, Kellow J, Tack J, Whitehead WE, editors. Rome IV functional gastrointestinal disorders: disorders of gut-brain interaction. I. Raleigh, NC: The Rome
134:
The Rome
Foundation, incorporated in 1996 and based in Raleigh, North Carolina, is an independent not for profit 501(c) 3 organization. The foundation provides support for activities which foster clinical research, data and educational information which aid in the diagnosis and treatment of
1041:
Drossman DA. The Rome IV Committees, editor. Functional
Gastrointestinal Disorders and the Rome IV process. In: Drossman DA, Chang L, Chey WD, Kellow J, Tack J, Whitehead WE, editors. Rome IV functional gastrointestinal disorders: disorders of gut-brain interaction.I. Raleigh, NC: The Rome
93:
In 1993, a validated questionnaire of all the diagnostic criteria was created and was then applied in a national survey, the US Householder Survey: the first national epidemiological database on the prevalence, demographic factors, and health care seeking features of people with FGIDs.
225:
After publication of Rome III in 2006, the Rome
Foundation was well recognized as the authoritative body developing diagnostic criteria for research and also for providing education about the FGIDs. Rome IV tried to address the limitations of a symptom-based criteria in several ways:
142:
The goals of the Rome
Foundation are to promote global recognition and legitimization of FGIDs, advance the scientific understanding of their pathophysiology, optimize clinical management for these patients and develop and provide educational resources to accomplish these goals.
250:
To help clinicians be better trained in the diagnostic algorithms and the MDCP, the Rome
Foundation is developing an interactive, intelligent software platform that will help clinicians make real-time treatment decisions using the diagnostic algorithms and MDCP knowledge
216:
After publication of Rome II, the number of studies published using the Rome criteria in clinical trials grew tremendously over the next 15 years. Rome III differed from Rome I and II by the use of more evidence-based rather than consensus-based data.
77:
and colleagues in
Bristol. This characterized IBS-D (IBS with predominant diarrhea), but importantly, a cluster of symptoms which were characteristic for this disorder. This ultimately became the basis for Rome's symptom-based criteria for IBS.
139:
dysfunction. This knowledge permits clinical scientists to make recommendations for diagnosis and treatment that can be applied in research and clinical practice. The mission is to improve the lives of people with these disorders.
208:
efforts of the Rome Foundation to improve the understanding, diagnosis, and treatment of FGIDs and to also apply the use of these criteria in their pharmaceutical studies. In Rome II, the pediatric population of FGIDs was added.
255:
In Rome IV, the classification moved from a physiologically based classification to a symptom-based classification. The classifications were based upon organ regions (i.e. esophageal, gastroduodenal, bowel, biliary, anorectal).
85:
From 1991 to 1993, several working teams (esophagus, gastroduodenal, bowel, biliary, anorectal) published symptom-based criteria and clinical features of the functional GI disorders within these anatomic domains in
747:
Drossman DA, Sandler RS, McKee DC, et al. Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 1982;83:529–534.
268:
The Rome criteria are a set of criteria used by clinicians to classify a diagnosis of a patient with an FGID (disorder of gut-brain interaction). These Rome criteria are updated every 6–10 years.
157:
Using the Delphi method, the Rome Foundation and its board of directors, chairs and co-chairs of the ROME IV committees developed the current definition for disorders of gut-brain interaction.
864:
Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders: prevalence, sociodemography and health impact. Dig Dis Sci 1993;38:1569–1580.
774:
Kruis W, Thieme CH, Weinzierl M, et al. A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease. Gastroenterology 1984;87:1–7.
880:
Drossman DA, Richter JE, Talley NJ, et al. The functional gastrointestinal disorders: diagnosis, pathophysiology and treatment. McLean (VA): Degnon Associates, 1994.
756:
Sandler RS, Drossman DA, Nathan HP, et al. Symptom complaints and health care seeking behavior in subjects with bowel dysfunction. Gastroenterology 1984;87:314–318.
698:
Chaudhary NA, Truelove SC. The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med 1962;31:307–322.
105:
the Rome II Criteria for IBS (1999) and the functional gastrointestinal disorders (1999) to the Rome III Criteria (2006). "Rome II" and "Rome III" incorporated
819:
Talley NJ, Colin-Jones D, Koch KL, et al. Functional dyspepsia: a classification with guidelines for diagnosis and management. Gastroenterol Int 1991;4:145–160
855:
Talley NJ, Nyren O, Drossman DA, et al. The irritable bowel syndrome: toward optimal design of controlled treatment trials. Gastroenterol Int 1993;4:189–211
1060:
Drossman DA, Corazziari E, Delvaux M, et al., eds. Rome III: the functional gastrointestinal disorders. 3rd ed. McLean (VA): Degnon Associates, 2006.
1051:
Drossman DA, Corazziari E, Talley NJ, et al., eds. Rome II: the functional gastrointestinal disorders. 2nd ed. McLean (VA): Degnon Associates, 2000.
837:
Corazziari E, Funch-Jensen P, Hogan WJ, et al. Working team report: functional disorders of the biliary tract. Gastroenterol Int 1993;6:129–144.
199:
In 1994, Rome I was published as The Functional Gastrointestinal Disorders:Diagnosis, Pathophysiology, and Treatment—A Multinational Consensus.
1127:
680:
152:
67:
39:
828:
Thompson WG, Creed F, Drossman DA, et al. Functional bowel disorders and chronic functional abdominal pain. Gastroenterol Int 1992;5:75–91
801:
Drossman DA, Thompson WG, Talley NJ, et al. Identification of subgroups of functional bowel disorders. Gastroenterol Int 1990;3:159–172.
792:
Thompson WG, Dotevall G, Drossman DA, et al. Irritable bowel syndrome: Guidelines for the diagnosis. Gastroenterol Int 1989;2:92–95.
607:
369:
765:
Talley NJ, Phillips SF, Melton LJ, et al. A patient questionnaire to identify bowel disease. Ann Intern Med 1989;111:671–674
1016:
434:
707:
Manning AP, Thompson WG, Heaton KW et al. Towards positive diagnosis of the irritable bowel. Br Med J 1978;2:653–654.
230:
Some criteria have been simplified and cases not meeting criteria for research can still be identified and treated.
846:
Whitehead WE, Devroede G, Habib FI, et al. Functional disorders of the anorectum. Gastroenterol Int 1992;5:92–108.
738:
Thompson WG, Heaton KW. Functional bowel disorders in apparently healthy people. Gastroenterology 1980;79:283–288.
233:
Global education on FGIDs help to understand and characterize the cross-cultural differences in symptom reporting.
1122:
167:
119:
391:
362:
99:
The Functional Gastrointestinal Disorders: Diagnosis, Pathophysiology and Treatment – A Multinational Consensus
729:
Torsoli A, Corazziari E. The WTR's, the Delphic Oracle and the Roman Conclaves Gastroenterol Int 1991;4:44–45.
55:
783:
Drossman DA. Diagnosis of the irritable bowel syndrome: A simple solution? Gastroenterology 1984;87:224–225
530:
182:
97:
In 1994, FGIDs were categorized into anatomical domains and resulted in a book now recognized as Rome I –
1069:
890:
Drossman DA, Hasler WL (2016). "Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction".
810:
Richter JE, Baldi F, Clouse RE, et al. Functional oesophageal disorders. Gastroenterol Int 1992;5:3–17
614:
319:
287:
43:
378:
631:
497:
930:"Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV"
1089:
949:
907:
474:
1081:
941:
899:
516:
300:
239:
Creation of diagnostic algorithms for a functional GI disorder diagnosis or other diagnosis
668:
447:
176:
74:
51:
1028:
1017:
https://theromefoundation.org/wp-content/uploads/Meet-The-Rome-Foundation-2017-web.pdf
147:
Definition of functional gastrointestinal disorders/disorders of gut-brain interaction
1116:
123:
554:
412:
1085:
945:
903:
506:
467:
929:
599:
281:
160:
A group of disorders classified by GI symptoms related to any combination of:
106:
563:
306:
35:
1093:
953:
911:
483:
424:
418:
352:
333:
46:
and rumination syndrome. The Rome diagnostic criteria are set forth by
17:
271:
The current Rome IV classification, published in 2016, is as follows:
348:
293:
34:
are an international effort to create scientific data to help in the
1107:
995:
453:
D2. Narcotic bowel syndrome (NBS)/ Opioid-induced GI hyperalgesia
73:
Subsequently, in 1978 came the "Manning Criteria" developed by
118:
The Rome criteria are achieved and finally issued through a
82:
year, a classification system for FGIDs was established.
441:
D. Centrally Mediated Disorders of Gastrointestinal Pain
245:
create an individualized treatment plan for the patient.
573:
H. Childhood Functional GI Disorders: Child/Adolescent
539:
G. Childhood Functional GI Disorders: Neonate/Toddler
66:
Several systematic approaches attempted to classify
27:Diagnostic criteria for gastrointestinal disorders
1015:"Meet the Rome Foundation," 2017. Retrieved from
923:
921:
584:H1b. Functional nausea and functional vomiting
458:E. Gallbladder and Sphincter of Oddi disorders
578:H1. Functional nausea and vomiting disorders
8:
358:B3a. Chronic nausea vomiting syndrome (CNVS)
512:F2b. Unspecified functional anorectal pain
876:
874:
872:
870:
430:C5. Unspecified functional bowel disorder
397:IBS with predominant constipation (IBS-C)
324:B1a. Postprandial distress syndrome (PDS)
236:Provide translations into other languages
1011:
1009:
990:
988:
986:
975:
973:
971:
969:
967:
965:
963:
725:
723:
721:
719:
717:
715:
713:
691:
135:functional gastrointestinal disorders.
681:Functional gastrointestinal disorders
526:F3a. Inadequate defecatory propulsion
400:IBS with predominant diarrhea (IBS-D)
68:functional gastrointestinal disorders
40:functional gastrointestinal disorders
7:
647:H3b. Nonretentive fecal incontinence
641:H3. Functional defecation disorders
636:H2d. Functional abdominal pain ‒ NOS
619:H2a1. Postprandial distress syndrome
523:F3. Functional defecation disorders
339:B2a. Excessive supragastric belching
153:Functional gastrointestinal disorder
42:, such as irritable bowel syndrome,
627:H2b. Irritable bowel syndrome (IBS)
581:H1a. Cyclic vomiting syndrome (CVS)
403:IBS with mixed bowel habits (IBS-M)
327:B1b. Epigastric pain syndrome (EPS)
172:Altered mucosal and immune function
550:G3. Cyclic vomiting syndrome (CVS)
25:
370:Cannabinoid hyperemesis syndrome
54:501(c)(3) organization based in
342:B2b. Excessive gastric belching
260:Rome IV criteria/classification
622:H2a2. Epigastric pain syndrome
502:F2. Functional anorectal pain
88:Gastroenterology International
32:Rome process and Rome criteria
1:
1086:10.1053/j.gastro.2006.03.011
1029:"Presentations & Videos"
946:10.1053/j.gastro.2016.02.032
904:10.1053/j.gastro.2016.03.035
644:H3a. Functional constipation
1128:Diagnostic gastroenterology
980:Foundation; 2016. pp. 1–32.
568:G7. Functional constipation
435:Opioid-induced constipation
313:B. Gastroduodenal Disorders
1144:
1042:Foundation; 2016. pp 1–32.
486:sphincter of Oddi disorder
190:Evolution of Rome criteria
150:
608:Functional abdominal pain
590:H1b2. Functional vomiting
423:C4. Functional abdominal
168:Visceral hypersensitivity
595:H1c. Rumination syndrome
544:G1. Infant regurgitation
473:E1b. Functional biliary
406:IBS unclassified (IBS-U)
392:Irritable bowel syndrome
363:Cyclic vomiting syndrome
587:H1b1. Functional nausea
559:G5. Functional diarrhea
547:G2. Rumination syndrome
446:D1. Centrally mediated
275:A. Esophageal Disorders
56:Raleigh, North Carolina
687:References and sources
531:Dyssynergic defecation
491:F. Anorectal Disorders
183:central nervous system
1000:theromefoundation.org
1068:Thompson WG (2006).
928:Drossman DA (2016).
615:Functional dyspepsia
320:Functional dyspepsia
288:Functional heartburn
164:Motility disturbance
44:functional dyspepsia
1108:The Rome Foundation
379:Rumination syndrome
130:The Rome Foundation
1070:"The Road to Rome"
632:Abdominal migraine
498:Fecal incontinence
385:C. Bowel Disorders
120:consensual process
475:sphincter of Oddi
463:E1. Biliary pain
58:, United States.
38:and treatment of
16:(Redirected from
1135:
1123:Gastroenterology
1097:
1080:(5): 1552–1556.
1074:Gastroenterology
1061:
1058:
1052:
1049:
1043:
1039:
1033:
1032:
1025:
1019:
1013:
1004:
1003:
992:
981:
977:
958:
957:
940:(6): 1262–1279.
934:Gastroenterology
925:
916:
915:
892:Gastroenterology
887:
881:
878:
865:
862:
856:
853:
847:
844:
838:
835:
829:
826:
820:
817:
811:
808:
802:
799:
793:
790:
784:
781:
775:
772:
766:
763:
757:
754:
748:
745:
739:
736:
730:
727:
708:
705:
699:
696:
659:Douglas Drossman
517:Proctalgia fugax
466:E1a. Functional
296:hypersensitivity
185:(CNS) processing
21:
1143:
1142:
1138:
1137:
1136:
1134:
1133:
1132:
1113:
1112:
1104:
1067:
1064:
1059:
1055:
1050:
1046:
1040:
1036:
1027:
1026:
1022:
1014:
1007:
994:
993:
984:
978:
961:
927:
926:
919:
889:
888:
884:
879:
868:
863:
859:
854:
850:
845:
841:
836:
832:
827:
823:
818:
814:
809:
805:
800:
796:
791:
787:
782:
778:
773:
769:
764:
760:
755:
751:
746:
742:
737:
733:
728:
711:
706:
702:
697:
693:
689:
677:
669:Nicholas Talley
656:
482:E2. Functional
450:syndrome (CAPS)
417:C3. Functional
411:C2. Functional
305:A5. Functional
280:A1. Functional
262:
223:
214:
205:
197:
192:
155:
149:
132:
116:
64:
48:Rome Foundation
28:
23:
22:
15:
12:
11:
5:
1141:
1139:
1131:
1130:
1125:
1115:
1114:
1111:
1110:
1103:
1102:External links
1100:
1099:
1098:
1063:
1062:
1053:
1044:
1034:
1020:
1005:
982:
959:
917:
898:(6): 1257–61.
882:
866:
857:
848:
839:
830:
821:
812:
803:
794:
785:
776:
767:
758:
749:
740:
731:
709:
700:
690:
688:
685:
684:
683:
676:
673:
672:
671:
666:
663:
660:
655:
654:Notable People
652:
651:
650:
649:
648:
645:
639:
638:
637:
634:
628:
625:
624:
623:
620:
604:
603:
602:
596:
593:
592:
591:
588:
582:
570:
569:
566:
560:
557:
551:
548:
545:
536:
535:
534:
533:
527:
521:
520:
519:
513:
510:
500:
488:
487:
480:
479:
478:
471:
455:
454:
451:
448:abdominal pain
438:
437:
431:
428:
421:
415:
409:
408:
407:
404:
401:
398:
382:
381:
375:
374:
373:
366:
359:
345:
344:
343:
340:
330:
329:
328:
325:
310:
309:
303:
297:
290:
284:
261:
258:
253:
252:
247:
246:
241:
240:
237:
234:
231:
222:
219:
213:
210:
204:
201:
196:
193:
191:
188:
187:
186:
179:
177:gut microbiota
173:
170:
165:
148:
145:
131:
128:
115:
112:
75:Kenneth Heaton
63:
60:
52:not for profit
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1140:
1129:
1126:
1124:
1121:
1120:
1118:
1109:
1106:
1105:
1101:
1095:
1091:
1087:
1083:
1079:
1075:
1071:
1066:
1065:
1057:
1054:
1048:
1045:
1038:
1035:
1030:
1024:
1021:
1018:
1012:
1010:
1006:
1001:
997:
991:
989:
987:
983:
976:
974:
972:
970:
968:
966:
964:
960:
955:
951:
947:
943:
939:
935:
931:
924:
922:
918:
913:
909:
905:
901:
897:
893:
886:
883:
877:
875:
873:
871:
867:
861:
858:
852:
849:
843:
840:
834:
831:
825:
822:
816:
813:
807:
804:
798:
795:
789:
786:
780:
777:
771:
768:
762:
759:
753:
750:
744:
741:
735:
732:
726:
724:
722:
720:
718:
716:
714:
710:
704:
701:
695:
692:
686:
682:
679:
678:
674:
670:
667:
665:Robin Spiller
664:
661:
658:
657:
653:
646:
643:
642:
640:
635:
633:
629:
626:
621:
618:
617:
616:
612:
611:
609:
605:
601:
597:
594:
589:
586:
585:
583:
580:
579:
577:
576:
575:
574:
567:
565:
561:
558:
556:
552:
549:
546:
543:
542:
541:
540:
532:
528:
525:
524:
522:
518:
514:
511:
508:
504:
503:
501:
499:
495:
494:
493:
492:
485:
481:
476:
472:
469:
465:
464:
462:
461:
460:
459:
452:
449:
445:
444:
443:
442:
436:
432:
429:
426:
422:
420:
416:
414:
410:
405:
402:
399:
396:
395:
393:
389:
388:
387:
386:
380:
376:
371:
367:
364:
360:
357:
356:
354:
350:
346:
341:
338:
337:
335:
331:
326:
323:
322:
321:
317:
316:
315:
314:
308:
304:
302:
298:
295:
291:
289:
285:
283:
279:
278:
277:
276:
272:
269:
266:
259:
257:
249:
248:
243:
242:
238:
235:
232:
229:
228:
227:
220:
218:
211:
209:
202:
200:
194:
189:
184:
180:
178:
174:
171:
169:
166:
163:
162:
161:
158:
154:
146:
144:
140:
136:
129:
127:
125:
124:Delphi method
121:
113:
111:
108:
102:
100:
95:
91:
89:
83:
79:
76:
71:
69:
61:
59:
57:
53:
49:
45:
41:
37:
33:
19:
1077:
1073:
1056:
1047:
1037:
1023:
999:
937:
933:
895:
891:
885:
860:
851:
842:
833:
824:
815:
806:
797:
788:
779:
770:
761:
752:
743:
734:
703:
694:
572:
571:
555:Infant colic
538:
537:
490:
489:
457:
456:
440:
439:
413:constipation
384:
383:
312:
311:
274:
273:
270:
267:
263:
254:
224:
215:
206:
198:
159:
156:
141:
137:
133:
122:, using the
117:
103:
98:
96:
92:
87:
84:
80:
72:
65:
47:
31:
29:
562:G6. Infant
507:Levator ani
468:gallbladder
427:/distension
1117:Categories
662:Brian Lacy
610:disorders
600:Aerophagia
484:pancreatic
355:disorders
336:disorders
282:chest pain
151:See also:
564:dyschezia
307:dysphagia
107:pediatric
36:diagnosis
1094:16678568
954:27144617
912:27147121
675:See also
509:syndrome
477:disorder
470:disorder
425:bloating
419:diarrhea
353:vomiting
334:Belching
212:Rome III
181:Altered
175:Altered
221:Rome IV
203:Rome II
114:Process
62:History
18:Rome IV
1092:
996:"Home"
952:
910:
394:(IBS)
349:Nausea
301:Globus
294:Reflux
195:Rome I
630:H2c.
613:H2a.
598:H1d.
529:F3b.
515:F2c.
505:F2a.
372:(CHS)
368:B3c.
365:(CVS)
361:B3b.
251:base.
1090:PMID
950:PMID
908:PMID
606:H2.
553:G4.
496:F1.
433:C6.
390:C1.
377:B4.
351:and
347:B3.
332:B2.
318:B1.
299:A4.
292:A3.
286:A2.
50:, a
30:The
1082:doi
1078:130
942:doi
938:150
900:doi
896:150
1119::
1088:.
1076:.
1072:.
1008:^
998:.
985:^
962:^
948:.
936:.
932:.
920:^
906:.
894:.
869:^
712:^
101:.
90:.
1096:.
1084::
1031:.
1002:.
956:.
944::
914:.
902::
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.