In December 2014, functional gastrointestinal disorder experts from many countries, including several who are sometimes mentioned on this blog, literally met in Rome, Italy to finalize the most recent revision to the Rome criteria. The Rome criteria are the international standard used to diagnose functional gastrointestinal disorders such as irritable bowel syndrome (IBS). Some version of the Rome criteria has been in existence for over two decades. Rome III is the current version. Rome IV, which these professionals were putting the final touches on developing two months ago, will now go through the usual process for publication in a gastroenterology journal and is expected to be released for use in 2016.
It not been made public yet just what changes and improvements have been made in the details of the criteria. However, earlier this month, in his February 2, 2015 Gut Feelings blog post, “Behind the Scenes at Rome Foundation IV: Updating FGIDs Diagnostic Criteria,” Douglas Drossman, MD, MACG, who is founder and president of the Rome Foundation, founder and president of the Drossman Center for the Education and Practice of Biopsychosocial Care, co-founder and retired co-director of the University of North Carolina Center for Functional GI Disorders, along with many other pivotal roles in the development of the field over his 40+ year career, reflects on the meeting. He also includes a video of a bit more than 7 minutes in length showing him and his colleagues in work sessions and meetings, interacting with each other more informally in hallways and in tours of the city of Rome, and speaking to the video camera about their impressions of the meeting and their hopes for their work on the criteria and on further functional GI research and treatment. The range of countries and research institutions they currently represent is vast, and their faces and voices are reminders that there were human beings working long and diligently through this complex process.
As IBS Impact has written previously on this blog, given relatively scant, simplistic coverage of IBS in the mainstream media and some online sources, many people with IBS who have not been exposed to or taken the opportunity to access high quality, state of the science sources, tend to believe erroneously that “nobody’s doing any research on IBS.” (See the December 28, 2014 post). If they are aware of the Rome criteria, these tend to be an abstraction ascribed to some faceless medical “system,” not something that, if properly put into practice, IBS experts like Dr. Drossman consistently state can adequately diagnose IBS and other functional GI disorders based on symptoms with an extremely high degree of accuracy.
This lack of awareness does not only extend to people with IBS and their families though. As also reported on this blog on October 9, 2011, and still largely true today, even almost a quarter century after Rome I, functional GI experts are still battling widespread misconceptions among their own medical colleagues– primary care physicians, general gastroenterologists and nurse practitioners in local communities– who are statistically much more likely than the experts to believe that IBS is still considered a diagnosis of exclusion, arrived at only when extensive tests have ruled out every other possibility and doctors do not know what else to call it or much about current standards of treating it. Despite the Rome Foundation members’ best efforts, as well as those of IBS organizations and advocates, these outdated notions filter down to patients and families and the public, compounding and prolonging an issue that is already entrenched but is a very basic barrier to further progress.
The best way to counter that is consistent and widespread education and awareness, which readers of this blog know IBS Impact actively encourages. The Rome Foundation is real. The Rome criteria are real, and the dedicated members of the various Rome IV working groups are real, highly experienced clinicians and researchers in the field. Take a look at Dr. Drossman’s video and see just a glimpse of behind the scenes.
IBS Impact thanks all of the experts involved in Rome IV, who are constantly working to improve diagnosis, treatment, research and functional GI education for those of us who live with these conditions and the professionals who may provide care to us. With IBS, progress is rarely quick and dramatic, and it is easy for many to lose hope that the future may bring new understanding, new options and better quality of life. But watching even a short, edited video may very possibly allow some readers that hope and insight.