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The pediatric Rome IV criteria: what's new?
Ilan J N Koppen1, Samuel Nurko2, Miguel Saps3
1a Department of Pediatric Gastroenterology and Nutrition , Emma Children's Hospital /Academic Medical Center , Amsterdam , the Netherlands.
Insights
The revised Rome IV criteria offer improved diagnosis for pediatric functional gastrointestinal disorders (FGIDs). These updates refine infant colic criteria and introduce new FGID categories for children and adolescents.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
Background:
- Functional gastrointestinal disorders (FGIDs) are prevalent in children and diagnosed using symptom-based criteria.
- FGIDs lack structural or biochemical abnormalities, presenting diagnostic challenges.
Purpose of the Study:
- To review the revised pediatric Rome IV criteria for diagnosing FGIDs.
- To highlight key changes in diagnostic criteria for neonates, toddlers, children, and adolescents.
Main Methods:
- Review of the published pediatric Rome IV criteria (2016).
- Analysis of revisions concerning infant colic, functional nausea, functional vomiting, and functional abdominal pain disorders.
Main Results:
- Significant revisions were made to infant colic criteria for neonates/toddlers.
- New FGID categories, functional nausea and functional vomiting, were defined for children/adolescents.
- Restructured criteria for functional abdominal pain disorders, including subtypes of functional dyspepsia and irritable bowel syndrome.
Conclusions:
- The Rome IV criteria represent a refinement in FGID diagnosis for pediatric populations.
- These updated criteria are expected to enhance clinical differentiation and benefit future research and patient care.
Introduction:
Functional gastrointestinal disorders (FGIDs) are common in children of all ages and comprise of a wide range of conditions related to the gastrointestinal tract that cannot be attributed to structural or biochemical abnormalities. FGIDs are diagnosed according to the symptom-based Rome criteria. Areas covered: In 2016, the revised pediatric Rome IV criteria were published, these revised criteria are discussed in this review article. For the youngest age group (neonates/toddlers), the criteria for infant colic have undergone the most notable revisions. The most prominent changes in Rome IV were made in the criteria for children/adolescents, with the definition of two new FGIDs (functional nausea and functional vomiting) and the restructuring of the criteria for functional abdominal pain disorders, including the definition of FGID subtypes for functional dyspepsia and irritable bowel syndrome. Expert commentary: Overall, the Rome IV have been refined and are expected to improve the process of diagnosing FGIDs in the pediatric population and to better facilitate the healthcare professional in distinguishing different clinical entities. These changes will likely benefit future research and clinical care.
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