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Updated: Mar 21, 2026

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Functional Disorders: Children and Adolescents.

Jeffrey S Hyams1, Carlo Di Lorenzo2, Miguel Saps3

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|May 5, 2016
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The Rome IV guidelines update childhood functional gastrointestinal disorders (FGIDs) diagnosis, shifting to symptom-based criteria and introducing new classifications for functional abdominal pain disorders.

Keywords:
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Area of Science:

  • Pediatric Gastroenterology
  • Functional Gastrointestinal Disorders
  • Diagnostic Criteria Evolution

Background:

  • Childhood functional gastrointestinal disorders (FGIDs) characterization has evolved over two decades through the Rome process.
  • The Rome IV criteria mark a significant shift from excluding organic disease to a symptom-based diagnostic approach.

Purpose of the Study:

  • To detail the changes in the Rome IV criteria for pediatric and adolescent functional gastrointestinal disorders.
  • To highlight the revised diagnostic approach, emphasizing symptom-based diagnosis over the exclusion of organic disease.

Main Methods:

  • Review and analysis of the Rome IV criteria for functional gastrointestinal disorders in children and adolescents.
  • Comparison of Rome IV diagnostic principles with previous iterations (Rome III).

Main Results:

  • Rome IV criteria now permit a positive diagnosis of FGIDs after appropriate medical evaluation, without requiring the exclusion of all organic disease.
  • New classifications include functional nausea and functional vomiting, and a revised category for functional abdominal pain disorders (FAPD).
  • A new term, 'functional abdominal pain - not otherwise specified,' is introduced for cases not fitting specific FAPD categories.

Conclusions:

  • The Rome IV guidelines enhance clarity for diagnosing pediatric FGIDs by adopting a more direct, symptom-focused methodology.
  • These updates are expected to improve diagnostic accuracy and consistency among clinicians and researchers in the field of pediatric functional gastrointestinal disorders.