Design: Population-based internet survey across 15 countries
Population: 28,771 adults
Primary outcome: Prevalence of disorders of gut-brain interaction by Rome V criteria
Effect: 40.9% with at least one disorder (Rome IV 40.5%)

The Rome Foundation surveyed 28,771 adults online in 15 countries using the new Rome V diagnostic questionnaire and compared the results with the earlier Rome IV global study.

At least one disorder of gut-brain interaction was present in 40.9%, against 40.5% under Rome IV. Prevalence was higher in women and fell with age. Functional dyspepsia (8.1%), chronic constipation (8.9%) and irritable bowel syndrome (8.5%) were among the commonest; unclassified bowel disorder was the most frequent bowel category (9.6%). Two new Rome V conditions, abdominal migraine (5.1%) and inability to belch (1.4%), were included for the first time.

The stability between criteria sets supports using Rome V in practice. For clinicians, the reminder is the scale: functional gut disorders are among the commonest problems seen.

Use Rome V criteria to make a positive diagnosis of functional gut disorders rather than diagnosing by exclusion.
Consider abdominal migraine in adults with recurrent episodic abdominal pain and migraine features.
Ask about inability to belch in patients with bloating and gurgling after meals.
Remember that unclassified bowel symptoms are common and still merit management.

Why it matters

It validates the Rome V criteria clinicians will now be expected to use.

The statistics, in plain English

Online surveys can over-represent people with symptoms, so absolute prevalence may be inflated; the close match with Rome IV using the same method is the more reliable finding.