Functional gastrointestinal disorders (FGIDs) are among the most challenging conditions to diagnose and manage. FGIDs are a heterogeneous group of conditions with varying and sometimes vague symptomatology. The Rome IV classification is the most comprehensive resource on FGIDs. FGIDs are common and are associated with significant social and economic burdens. The patient perspective includes anxiety, emotional distress, and mistrust of health care. Psychological stressors and concomitant psychiatric illness are common but not always present. Clinician understanding of these disorders is limited, and there are many barriers to adequate care. A strong clinician-patient relationship is essential. Management includes education, reassurance, dietary modification, pharmacotherapy, and psychological interventions.