See article on page 527 Functional bowel disorders are highly prevalent in the general population. In the US Householder Survey about 70% of respondents had at least one functional bowel disorder, 9.4% had irritable bowel syndrome (IBS) and 2.9% had functional dyspepsia.1 These disorders often have significant symptom overlap making them difficult to distinguish.2 3 In this issue (see page 527), Chassany et al describe the initial development, preliminary psychometric testing and cross-cultural assessment of a multi-item disease specific health related quality of life (HRQOL) instrument for use in multinational clinical trials of IBS or functional dyspepsia. If only an efficacious therapy could be found! Health related quality of life assessment is becoming increasingly recognised as an important outcome and predictor for patients with chronic diseases. HRQOL is generally assessed by quantitative questionnaires completed by patients themselves which assess physical and psychosocial attitudes and function. The three kinds of HRQOL measures used in research and practice include global assessments, generic instruments and disease specific instruments.4 5The global assessment, usually a graded summary such as good, fair or poor or a 10 cm visual analog scale, may help to predict a relation between simple parameters, like disease severity and function, but is often inadequate for more sophisticated hypothesis testing. Generic instruments are multi-item problem lists that are meant to be independent of sex, age and disease and are applied to compare …