Abstract：Functional gastrointestinal disorders (FGIDs),the most common diseases in gastroenterology,are recognized by morphologic and physiological abnormalities which often occur in combination including motility disturbance,increased vagal excitability,altered mucosal and immune function,altered gut microbiota,and altered central nervous system processing.Research on these gut-brain interaction disorders is based on using specific diagnostic criteria.The Rome Foundation has played a pivotal role in creating diagnostic criteria,thus new knowledge in the field of FGIDs should be disseminated.Rome Ⅳ is a compendium of the accumulated knowledge since Rome Ⅲ was published 10 years ago.It improves upon Rome Ⅲ by:(1)updating the basic and clinical literatures;(2)offering new information on gut microenvironment,gut-brain interactions,pharmacogenomics,biopsychosocial,gender and cross-disciplinary understandings of FGIDs;(3)reducing the use of imprecise and occasionally stigmatizing terms when possible;(4)using updated diagnostic criteria;(5)incorporating information on illness experience,and physiological subgroups or biomarkers of patient that may lead to more targeted treatment.This introductory article offers a historical overview of the FGIDs field,differentiates FGIDs from motility and structural disorders,discusses the changes from Rome Ⅲ,reviews the Rome committee,provides a biopsychosocial and pathophysiological conceptualization of FGIDs,and offers an approach to patient care.
