胃肠病学和肝病学杂志

罗马Ⅳ强调功能性肠病(functional bowel disorders,FBD)是一组具有相同病理生理机制的连续症状谱,这种概念框架有助于我们更好地理解FBDs中普遍存在的重叠和转换现象。罗马Ⅳ在肠易激综合征的诊断标准中删去了"腹部不适",调整了功能性腹泻等疾病的诊断频度阈值,提出功能性腹胀和腹部膨胀具有不同的病理生理机制,为各种特异性FBD诊断和治疗提出了切实可行的建议。我们需要充分认识到国人FBD的临床表现特点,结合我国的实际情况灵活应用罗马Ⅳ诊断标准。

A new conceptual framework of functional bowel disorders( FBD) is used by Rome Ⅳ experts to explain FBDs as a spectrum continuum from pathophysiologic mechanisms,which might help us to understand the common overlapping and transition between different disorders in FBD patients. In the Rome Ⅳ criteria,"abdominal discomfort"was deleted from irritable bowel syndrome diagnostic criteria,the frequency thresholds for functional diarrhea and other specified disorders were adjusted. Functional abdominal bloating and distension have different pathophysiological underpinnings. The committee also provides practical recommendations of diagnosis and treatment for specified FBD. We need to recognize the characteristics of symptoms and pathophysiologic mechanisms in Chinese patients with FBD while we apply the Rome Ⅳ criteria in our clinical practice.