Comments on Rome criteria of functional gastrointestinal disorders

The following comments and critical remarks on Rome criteria are submitted on the basis of 50 years' experience: Rome criteria do not distinguish between non-organic disturbances which are truly digestive and those which are neuropathic or psychopathic. Yet the distinction is important both theoretically and practically. Dyspepsia is defined as pain or discomfort in the epigastrium but distinction of both terms is important for identification of subgroups and for therapy. An alternative and useful basis for definitions of functional digestive disorders is the sensations accompanying eating and defecation. Rome criteria disregard the fact that the distinction of functional from organic is not in the symptoms themselves but rather in the circumstances in which they appear or disappear. In Rome criteria some conditions are incorrectly interpreted (globus, aerophagia) and some typical syndromes are not mentioned namely fermentative enteropathy (carbohydrate dyspepsia) and pain arising in the abdominal nervous plexus - solar (celiac plexus) syndrome.