The irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder (FGID), also called disorders of the gut-brain interaction (DGBI). Over the years, the definition and classification of IBS suffered several conceptual changes. The work of the Rome Committees has largely contributed to the progress in knowledge and awareness of IBS. This paper is an overview of the evolution of diagnosis and classification criteria of IBS. Background: The majority of the complaints causing presentation to the general gastroenterological centers are represented by FGID. IBS is the most frequent among them. IBS is not a uniform condition but includes an array of particular forms called subtypes. Criteria for the identification of the IBS subtypes have suffered several changes in parallel with the accumulation of scientific evidence about this disorder. Classification of IBS subtypes relies on symptoms. Summary: This is a review of the evolution of the criteria for diagnosis and classification of IBS subtypes. Starting with older names given to IBS, some changes in definition and diagnosis have been operated by each edition of the Rome criteria. These changes have led to the better identification of patients with IBS. The management of IBS depends on subtypes and should be individualized. Key Messages: IBS is the main FGID, called also DGBI. It is not a homogenous disorder but a generic name for an array of subtypes with common features but with clinical differences. The diagnosis and classification of IBS subtypes have evolved in time, in accordance with the progress of the knowledge on pathogenesis. It is important for healthcare providers to recognize the subtypes and to use a common nomenclature (that offered by the Rome Committees work).

The Gastrointestinal (GI) tract is one of the most affected systems by alcohol consumption. Alcohol can affect the esophagus in several ways: induces mucosal inflammation, increases the risk for Barrett esophagus and esophageal cancer, and also impairs the esophageal motility. Numerous studies have reported an increased prevalence of Gastroesophageal Reflux Disease (GERD) or erosive esophagitis in alcoholics. Some alcoholics exhibit an abnormality of esophageal motility known as a "nutcracker esophagus". Alcohol effect on gastric motility depends on the alcohol concentration. In general, beverages with high alcohol concentrations (i.e., above 15 percent) appear to inhibit gastric motility and low alcohol doses (wine and beer) accelerate gastric emptying. Also, acute administration of ethanol inhibits the gastric emptying, while chronic administration of a large dose of alcohol accelerates gastric motility. The effect of alcohol on small bowel motility differs according to the type of consumption (acute or chronic). Acute administration of alcohol has been found to inhibit small bowel transit and chronic administration of a large dose of alcohol accelerates small bowel transit. This article reviews some of the below findings.

Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms.

Background and Aims: The nonpharmacological therapy in irritable bowel syndrome (IBS) is expanding rapidly. Practitioners and medical educators need to be aware of progress and changes in knowledge of this topic. The Romanian Society of Neurogastroenterology aimed to create guidelines based on best evidence on the use of nonpharmacological therapy in IBS. Methods: A group of experts was constituted. This was divided in eleven subgroups dedicated to eleven categories of nonpharmacological therapy. The subgroups searched the literature and formulated statements and recommendations. These were submitted to vote in order to obtain consensus. Results: The outcome of this activity is represented by the guidelines of the Romanian Society of Neurogastroenterology, presented in this paper. The recommendations are seen as complementary to the pharmacological therapy and are not intended to recommend avoiding pharmacological drugs. Conclusions: These guidelines were elaborated by a Delphi process and represent a useful tool for physicians managing patients with IBS.

Background and Summary. Chronic abdominal pain is a challenging complaint for both primary care providers and gastroenterologists alike, due to a broad differential diagnosis and sometimes extensive and negative workup. In the absence of red flag features that herald more acute conditions, the majority of patients with chronic abdominal pain have a benign cause or a functional disorder (e.g. Irritable bowel syndrome). The costs associated with a diagnostic workup are an expensive burden to healthcare. A systematic approach for evaluating patients and initiating a management plan are recommended in the primary care setting. Undiagnosed abdominal pain should be investigated starting with a detailed history and physical examination. Diagnostic investigations should be limited and adapted according to the clinical features, the alarm symptoms, and the symptom severity. This review will focus on the diagnostic tools which general practitioners (GP) utilize in the evaluation of chronic abdominal pain. Key Messages. The primary role of the general practitioner (GP) is to differentiate an organic disease from a functional one, to refer to a specialist, or to provide treatment for the underlying cause of pain. The functional disorders should be considered after the organic pathology has been confidently excluded. Once a diagnosis of functional pain is established, repetitive testing is not recommended and the patient should be referred to receive psychological support (e.g. cognitive therapy) associated with available pharmacological therapeutic options.