Functional Bowel Disorders, Gastroenterology, 2006

Employing a consensus approach, our working team
critically considered the available evidence and multinational
expert criticism, revised the Rome II diagnostic
criteria for the functional bowel disorders, and
updated diagnosis and treatment recommendations.
Diagnosis of a functional bowel disorder (FBD) requires
characteristic symptoms during the last 3
months and onset >6 months ago. Alarm symptoms
suggest the possibility of structural disease, but do
not necessarily negate a diagnosis of an FBD. Irritable
bowel syndrome (IBS), functional bloating, functional
constipation, and functional diarrhea are best identified
by symptom-based approaches. Subtyping of IBS
is controversial, and we suggest it be based on stool
form, which can be aided by use of the Bristol Stool
Form Scale. Diagnostic testing should be guided by
the patient’s age, primary symptom characteristics,
and other clinical and laboratory features. Treatment
of FBDs is based on an individualized evaluation,
explanation, and reassurance. Alterations in diet, drug
treatment aimed at predominant symptoms, and psychotherapy
may be beneficial.

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