Case-based Diagnostic Algorithms and Multidimensional Clinical Profiles for common Disorders of Gut-Brain Interaction using Rome V criteria.

Abstract

The accurate diagnosis of disorders of gut-brain interaction (DGBI), such as functional dyspepsia and irritable bowel syndrome, is crucial for improving patient symptoms, outcomes and ultimately, quality of life. However, busy clinicians often face challenges in diagnosing and managing these conditions, particularly when patients present with non-specific gastrointestinal symptoms together with psychosocial distress and/or social issues. DGBI are among the most common reasons for gastroenterology referral, with a global prevalence of approximately 40% in adults based on large-scale epidemiologic studies. While diagnostic algorithms aid in positively identifying DGBI, they often overlook key factors influencing treatment decisions. The Rome V Multidimensional Clinical Profile (MDCP) offers a comprehensive, patient-centered framework that extends beyond diagnosis alone. It integrates five core domains: (1) the primary diagnosis, (2) clinical modifiers, (3) impact on daily activities and quality of life, (4) psychosocial modifiers, and (5) physiological features and biomarkers. By considering comorbidities, illness severity, psychosocial contributors, and potential biomarkers, the MDCP enables clinicians to develop a holistic understanding of the patient's condition. This multidimensional approach facilitates tailored, evidence-based treatment plans that address the biopsychosocial aspects of DGBI, ultimately enhancing symptom management and patient well-being. Furthermore, it highlights gaps in knowledge and stimulates targeted research into these highly prevalent disorders. This case-oriented educational review will evaluate three DGBIs - functional dyspepsia, irritable bowel syndrome, and chronic abdominal pain - using the MDCP approach.