Disorders of Gut-Brain Interaction and the Rome V Process.

Douglas A Drossman, Lin Chang, Jan Tack

Journal: Gastroenterology 2026;170(6):1083-1098

PMID: 42031435

Abstract

Disorders of gut-brain interaction (DGBI) are characterized by gastrointestinal symptoms related to any combination of motility disturbance, visceral hypersensitivity, altered mci function, altered gut microbiota, or altered central nervous system processing. Research on and clinical management of DGBI is based on selective diagnostic criteria, generated through the Rome Foundation. The Rome V process generated a broad overview of the knowledge accumulated since Rome IV was published 10 years ago, with a focus on evidence-based adjustments. It builds on (1) an update of the DGBI definitions based on the latest basic and clinical literature; (2) offering new information on the role of diet, gut microenvironment, gut-brain interactions, pharmacogenomics, biopsychosocial, gender and cross-cultural factors; (3) reducing the use of imprecise or stigmatizing terms; (4) generating updated diagnostic algorithms; (5) incorporating information on the patient illness experience and sociocultural aspects; and (6) updating the therapeutic approaches to DGBI.

Address: The Rome Foundation, Chapel Hill, North Carolina.; The Rome Foundation, Chapel Hill, North Carolina; Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, California.; The Rome Foundation, Chapel Hill, North Carolina; Translational Research Center for Gastrointestinal Disorders, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: [email protected].

DOI: 10.1053/j.gastro.2026.02.014

MeSH Terms: Humans, Gastrointestinal Diseases, Brain, Brain-Gut Axis, Gastrointestinal Microbiome