medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-232medsovet-10201Research ArticleЗАБОЛЕВАНИЯ ПИЩЕВОДА И ЖЕЛУДКАESOPHAGEAL AND GASTRIC DISEASESРимские критерии V пересмотра (2026): преемственность и ключевые измененияRome V Criteria (2026): Continuity, innovations and major updateshttps://orcid.org/0000-0001-6114-564XМаевИ. В.MaevI. V.

Маев Игорь Вениаминович - академик РАН, д.м.н., профессор, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии лечебного факультета Научно-образовательного института клинической медицины имени Н.А. Семашко.

127006, Москва, ул. Долгоруковская, д. 4

Igor V. Maev - Acad. RAS, Dr. Sci. (Med.), Professor, Head of the Department of Propaedeutics of Internal Diseases and Gastroenterology, Faculty of Medicine, Semashko Scientific and Educational Institute of Clinical Medicine.

4, Dolgorukovskaya St., Moscow, 127006

ProRekt-02@msmsu.ruhttps://orcid.org/0000-0002-4007-7112АндреевД. Н.AndreevD. N.

Андреев Дмитрий Николаевич - к.м.н., доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии лечебного факультета Научно-образовательного института клинической медицины имени Н.А. Семашко.

127006, Москва, ул. Долгоруковская, д. 4

Dmitriy N. Andreev - Cand. Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Diseases and Gastroenterology, Faculty of Medicine, Semashko Scientific and Educational Institute of Clinical Medicine.

4, Dolgorukovskaya St., Moscow, 127006

dna-mit8@mail.ruhttps://orcid.org/0000-0002-7923-9916ЗаборовскийА. В.ZaborovskiyA. V.

Заборовский Андрей Владимирович - д.м.н., профессор, заведующий кафедрой фармакологии лечебного факультета Научно-образовательного института клинической медицины имени Н.А. Семашко.

127006, Москва, ул. Долгоруковская, д. 4

Andrey V. Zaborovskiy - Dr. Sci. (Med.), Professor, Head of the Department of Pharmacology, Faculty of Medicine, Semashko Scientific and Educational Institute of Clinical Medicine.

4, Dolgorukovskaya St., Moscow, 127006

zaborovsky_av@msmsu.ruhttps://orcid.org/0000-0003-2813-6498СоколовФ. С.SokolovF. S.

Соколов Филипп Сергеевич - преподаватель кафедры фармакологии лечебного факультета Научно-образовательного института клинической медицины имени Н.А. Семашко.

127006, Москва, ул. Долгоруковская, д. 4

Filipp S. Sokolov - Lecturer of the Department of Pharmacology, Faculty of General Medicine, Semashko Scientific and Educational Institute of Clinical Medicine.

4, Dolgorukovskaya St., Moscow, 127006

phlppsokolov@gmail.comhttps://orcid.org/0000-0002-1794-7263ФоменкоА. К.FomenkoA. K.

Фоменко Алексей Константинович - преподаватель кафедры фармакологии лечебного факультета Научно-образовательного института клинической медицины имени Н.А. Семашко.

127006, Москва, ул. Долгоруковская, д. 4

Alexey K. Fomenko - Lecturer of the Department of Pharmacology, Faculty of Medicine, Semashko Scientific and Educational Institute of Clinical Medicine.

4, Dolgorukovskaya St., Moscow, 127006

docfomenko@yandex.ruРоссийский университет медицины (РосУниМед)РоссияRussian University of Medicine (ROSUNIMED)Russian Federation20260107202608821Copyright © Маев И.В., Андреев Д.Н., Заборовский А.В., Соколов Ф.С., Фоменко А.К., 20262026Маев И.В., Андреев Д.Н., Заборовский А.В., Соколов Ф.С., Фоменко А.К.Maev I.V., Andreev D.N., Zaborovskiy A.V., Sokolov F.S., Fomenko A.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10201

В 2026 г. опубликован V пересмотр Римских критериев (РК V), отражающий современную концепцию расстройств взаимодействия кишечника и головного мозга (РВКМ) как самостоятельной группы заболеваний, связанных с нарушениями висцеральной чувствительности, регуляции оси «кишечник – головной мозг», иммуновоспалительных и психофизиологических механизмов. Актуальность данного обзора определяется высокой распространенностью РВКМ, их частым сочетанием между собой, значимым влиянием на качество жизни пациентов и необходимостью адаптации новых международных диагностических подходов к практической гастроэнтерологии. Обзор основан на анализе публикаций Rome Foundation, консенсусных документов, клинических рекомендаций, систематических обзоров, метаанализов и оригинальных исследований, посвященных диагностике, патофизиологии и лечению РВКМ. Особое значение РК V связано с переходом от преимущественно симптомориентированного описания функциональных расстройств к клинико-инструментальной модели диагностики, основанной на сочетании симптоматических критериев, критериев исключения органической патологии и современных инструментальных стандартов. Лионский консенсус 2.0 и Чикагская классификация v4.0 теперь являются обязательными элементами диагностики функциональных расстройств пищевода. Функциональная импедансная планиметрия существенно повышает специфичность диагностики функциональной дисфагии. В синдром раздраженного кишечника (СРК) возвращены «дискомфорт» и более низкий порог частоты симптомов, что может повысить выявляемость заболевания в популяциях, где боль воспринимается или описывается менее интенсивно. Синдром невозможности отрыжки получил статус самостоятельной нозологии с конкретными диагностическими и терапевтическими критериями. Дополнительно в РК V уточнены подходы к хроническому запору, функциональной диарее, билиарным и аноректальным расстройствам, а также усилена роль поведенческих вмешательств, нейромодуляторов и мультидисциплинарного ведения пациентов.

In 2026, the fifth revision of the Rome criteria (Rome V) was published, reflecting the current concept of disorders of gut–brain interaction (DGBI) as an independent group of diseases associated with impaired visceral sensitivity, dysregulation of the gut-brain axis, and immune-inflammatory and psychophysiological mechanisms. The relevance of this review is determined by the high prevalence of DGBI, their frequent overlap, their substantial impact on patients’ quality of life, and the need to adapt new international diagnostic approaches to routine gastroenterological practice. The particular importance of Rome V is associated with the transition from a predominantly symptom-oriented description of functional disorders to a clinical and instrumental diagnostic model based on the combination of symptom criteria, criteria for excluding organic pathology, and modern instrumental standards. Publications were excluded if the full text was unavailable, if they were not relevant to DGBI, if they duplicated previously published data, or if their findings could not be correlated with current diagnostic criteria. The Lyon Consensus 2.0 and the Chicago Classification v4.0 are now considered essential components in the diagnosis of functional esophageal disorders. Functional impedance planimetry significantly improves the diagnostic specificity for functional dysphagia. In irritable bowel syndrome (IBS), the symptom of “discomfort” and a lower symptom-frequency threshold have been reinstated, which is expected to improve case identification in populations where pain is perceived or reported less intensely. Retrograde cricopharyngeal dysfunction (R-CPD), commonly referred to as the inability-to-burp syndrome, has been recognized as a distinct clinical entity with specific diagnostic and therapeutic criteria.

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The authors declare that there are no conflicts of interest present.