Competing interests: MCD has no relevant competing interests. NJT reports non-financial support from Norgine (2021)(IBS interest group), personal fees from Allakos (gastric eosinophilic disease) (2021), Bayer (IBS)(2020), Planet Innovation (Gas capsule IBS) (2020), twoXAR Viscera Labs (USA 2021) (IBS-diarrhoea), Dr Falk Pharma (2020)(EoE), Sanofi-aventis, Glutagen (2020) (Celiac disease), IsoThrive (2021) (oesophageal microbiome), BluMaiden (microbiome advisory board) (2021), Rose Pharma (IBS) (2021), Intrinsic Medicine (2022) (human milk oligosaccharide), Comvita Manuka Honey (2021) (digestive health), AstraZeneca (2022), outside the submitted work; in addition, NJT has a patent Nepean Dyspepsia Index (NDI) 1998, Biomarkers of IBS licensed, a patent Licensing Questionnaires Talley Bowel Disease Questionnaire licensed to Mayo/Talley, a patent Nestec European Patent licensed, and a patent Singapore Provisional Patent ‘Microbiota Modulation of BDNF Tissue Repair Pathway’ issued, ‘Diagnostic marker for functional gastrointestinal disorders’ Australian Provisional Patent Application 2021901692. Committees: OzSage, Australian Medical Council (AMC) (Council Member); Australian TeleHealth Integration Programme; NHMRC Principal Committee (Research Committee) Asia Pacific Association of Medical Journal Editors, Rome V Working Team Member (Gastroduodenal Committee), International Plausibility Project Co-Chair (Rome Foundation funded), COVID-19 vaccine forum member (by invitation only). Community group: Advisory Board, IFFGD (International Foundation for Functional GI Disorders), AusEE. Editorial: Medical Journal of Australia (Editor in Chief), Up to Date (Section Editor), Precision and Future Medicine, Sungkyunkwan University School of Medicine, South Korea, Med (Journal of Cell Press). NJT is supported by funding from the National Health and Medical Research Council (NHMRC) to the Centre for Research Excellence in Digestive Health and he holds an NHMRC Investigator grant.