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Combining Rome III criteria with alarm symptoms provides high specificity but low sensitivity for functional

Agneta Uusijärvi1,2, Ola Olén2,3,4, Petter Malmborg3,5

  • 1Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|February 28, 2018
PubMed

Insights

The Rome III criteria combined with no alarm symptoms accurately identify functional gastrointestinal disorders in children but miss many cases. Further diagnostic tools are needed for accurate pediatric GI diagnosis.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Diagnostics
  • Functional Gastrointestinal Disorders

Background:

  • Differentiating organic and functional gastrointestinal diagnoses in children is clinically challenging.
  • The Rome III criteria and alarm symptoms are commonly used but require validation in pediatric populations.

Purpose of the Study:

  • To validate the Rome III criteria and alarm symptoms for distinguishing organic from functional gastrointestinal diagnoses in pediatric patients.
  • To assess the diagnostic accuracy of these tools in children presenting with gastrointestinal complaints.

Main Methods:

  • A cohort of 258 children (aged 4–17) with gastrointestinal complaints were evaluated.
  • Symptom questionnaires based on the Rome III criteria and alarm symptoms were administered.
  • Medical records underwent diagnostic review to establish reference diagnoses.

Main Results:

  • Functional gastrointestinal disorders (FGDs) were diagnosed in 84% of children (54% pain-predominant).
  • Rome III criteria plus absence of alarm symptoms showed high specificity (0.90) but low sensitivity (0.15) for FGDs.
  • Alarm symptoms were prevalent in both organic (83%) and functional (80%) diseases.

Conclusions:

  • The combination of Rome III criteria and absence of alarm symptoms offers high specificity but limited sensitivity for diagnosing pediatric functional gastrointestinal disorders.
  • These tools alone are insufficient for comprehensive diagnosis, highlighting the need for improved diagnostic strategies in pediatric gastroenterology.
Abstract

Keywords:
Alarm symptomsFunctional dyspepsiaIrritable bowel syndromeQuestionnaire validation

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