The Road from Rome V to the Pediatric Clinic: New Perspectives in 2026.

Rome V marks a paradigm shift in pediatric disorders of gut-brain interaction (DGBI). The new Rome V criteria introduced new, updated, and refined definitions for pediatric DGBI. A central feature of this framework is the shift toward anchoring diagnoses more firmly in pathophysiology and anatomic regions rather than age groups. Accordingly, the criteria are now organized into two major categories: upper gastrointestinal DGBI and lower gastrointestinal and biliary DGBI. Several new disorders have been added, including esophageal, feeding, and discomfort disorders, along with additional pain-related conditions. Existing criteria have been further refined, and emerging biomarkers are incorporated to support diagnoses. Finally, there is greater harmony between adult and pediatric diagnoses to support a seamless transition across the age continuum.