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From Rome to Montreal: what is the consequence of consensus? ▸

Twenty years ago the literature was full of varying definitions of functional gastrointestinal disorders, which was impeding research. A degree of homogeneity has been brought about by the Rome committee, who have regularly updated their definitions with the Rome II and now Rome III classifications of functional gastrointestinal disease. The Montreal group have attempted to bring a similar degree of consensus to the definition of gastro-oesophageal reflux and related diseases. The group consisted of experts from 18 countries, with the disciplines of gastroenterology, primary care and surgery represented. A rigorous Modified Delphi process was used to reach consensus and >67% agreement was reached on all 51 statements. The definitions varied from the benign “GORD is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications” to the contentious “When biopsies of endoscopically suspected oesophageal metaplasia show columnar epithelium it should be called Barrett’s esophagus and the presence or absence of intestinal-type metaplasia specified”.

The consensus group should be congratulated on the rigorous process they …

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