Bowel Disorders

Functional bowel disorders are highly prevalent disorders found worldwide. These disorders have the potential to affect all members of society, regardless of age, sex, race, creed, color, or socioeconomic status. Improving our understanding of functional bowel disorders (FBD) is critical, as they impose a negative economic impact to the global health care system in addition to reducing quality of life. Research in the basic and clinical sciences during the past decade has produced new information on the epidemiology, etiology, pathophysiology, diagnosis, and treatment of FBDs. These important findings created a need to revise the Rome III criteria for FBDs, last published in 2006. This article classifies the FBDs into 5 distinct categories: irritable bowel syndrome, functional constipation, functional diarrhea, functional abdominal bloating/distention, and unspecified FBD. Also included in this article is a new sixth category, opioid-induced constipation, which is distinct from the functional bowel disorders (FBDs). Each disorder will first be defined, followed by sections on epidemiology, rationale for changes from prior criteria, clinical evaluation, physiologic features, psychosocial features, and treatment. It is the hope of this committee that this new information will assist both clinicians and researchers in the decade to come.