Rome V reflects continued progress in neurogastroenterology — moving from symptom-based classification toward a systems-oriented model of gut–brain interaction. Every change in Rome V is supported by evidence, including validation studies of questionnaires.

Clarity

• Standardized DGBI diagnoses with a clear separation of clinical and research criteria
• IBS criteria updated to re-include discomfort alongside pain
• Pediatric criteria reclassified by upper and lower GI anatomy
• “Functional” terminology is minimized in favor of physiologically accurate language

Science

• Every update supported by evidence, including questionnaire validation studies
• Expanded diagnostic algorithms for greater clinical precision
• Incorporates global epidemiology, translational research, and outcomes data

Patient-Centered Care

• New, formally recognized diagnoses based on accumulated clinical evidence
• Multidisciplinary care was incorporated, including dietary and behavioral interventions alongside pharmacologic approaches
• Expanded Patient Experience framework integrating social determinants of health
• Life stage–specific and LGBTQ+ health considerations included

Rome V formally separates research diagnostic criteria from clinical diagnostic criteria — recognizing that the goals of scientific investigation and patient care, while related, are not identical.

Research criteria for clinical trials include defined thresholds, standardized endpoints, and reproducibility. Clinical criteria are designed for practice: flexible, judgment-informed, and reflective of how patients actually present.

This distinction improves methodological rigor in research while supporting more confident, practical decision-making at the point of care.

Research Criteria

• Developed to promote uniformity across clinical trials
• Defined symptom frequency and duration thresholds
• Standardized endpoints to support reproducibility

Clinical Diagnostic Criteria

• Designed to guide real-world patient care
• Allow for clinical judgment and individual patient context
• Incorporate symptom bothersomeness and functional impact

Rome V introduces new diagnostic entities based on years of accumulated evidence, global epidemiology, and frontline clinical experience:

• Inability to Belch (Retrograde Cricopharyngeal Dysfunction)
• Adult Abdominal Migraine
• Anorectal Sensory Dysfunction

These additions are the result of a structured, international, multidisciplinary review process. They are not trend-driven inclusions — each reflects sustained evidence and the collaborative work of expert committees worldwide.

Rome V expands its commitment to patient-centered care by formally integrating the broader context in which symptoms are experienced and care is delivered. The use of “functional” terminology has been minimized in favor of language that better reflects physiologic understanding and reduces stigma. Where it is retained — as in functional diarrhea, functional chest pain, and functional heartburn — it is applied with greater precision.

Rome V’s expanded Patient Experience framework includes:

• Social determinants of health and their impact on symptom severity and access to care
• Sexual and gender minority health considerations (LGBTQ+)
• Life stage–specific clinical guidance
• The role of early life adversity in DGBI development

Rome V reorganizes pediatric DGBI criteria by anatomical region — upper and lower GI — rather than age-based groupings. This structural change aligns pediatric and adult diagnostic frameworks, supports continuity of care across the lifespan, and reflects advances in developmental neurogastroenterology.

Rome V is developed through an international, committee-driven process involving more than 140 experts from 27 countries. Multidisciplinary editorial teams, global board representation, and collaborative partnerships with leading societies worldwide ensure that Rome V reflects both the breadth of current evidence and the realities of clinical practice.

What is new in Rome V compared to Rome IV?

Every update in Rome V is supported by evidence, including validation studies of questionnaires. Key changes include: formally separated research and clinical diagnostic criteria; updated IBS criteria that re-include discomfort and lower the diagnostic threshold; expanded diagnostic algorithms with more detailed treatment recommendations; new formally recognized diagnoses; pediatric criteria reclassified by GI anatomy; formal integration of multidisciplinary care including dietary and behavioral interventions; and minimized use of “functional” terminology in favor of physiologically precise language.

When does Rome V ship?

June 1, 2026.

Who should purchase Rome V?

Rome V is designed for gastroenterologists, pediatricians, psychiatrists, primary care clinicians, dietitians, psychologists, integrative practitioners, researchers, and trainees.