Lower and Biliary Disorders of Gut-Brain Interaction: Child and Adolescent.

Di Lorenzo, Carlo; Saps, Miguel; Chumpitazi, Bruno P; Rajindrajith, Shaman; Staiano, Annamaria; Thapar, Nikhil; van Tilburg, Miranda; Velasco-Benítez, Carlos et al. · Gastroenterology · 2026

review · Level V

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Abstract

Rome V provides updated criteria for pediatric disorders of gut-brain interaction, replacing age-based subdivisions with a classification based on the following regions and symptom patterns: abdominal pain disorders, defecation and anorectal disorders, and discomfort disorders. New entities were introduced, including biliary pain syndrome, centrally mediated abdominal pain syndrome, functional abdominal bloating, and proctalgia fugax. The term "infantile colic" has been replaced with "infant distress syndrome." Existing criteria for irritable bowel syndrome, functional constipation, and nonretentive fecal incontinence were revised to improve diagnostic clarity and reflect current clinical understanding. Rome V also acknowledges that disorders of gut-brain interaction may coexist with other conditions producing gastrointestinal symptoms. These updates are intended to support a more consistent diagnostic framework and guide appropriate management strategies for children and adolescents.

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