The Effects of the Rome IV Criteria on Pediatric Gastrointestinal Practice

Area of Science:

• Pediatric Gastroenterology
• Functional Gastrointestinal Disorders
• Diagnostic Criteria

Background:

• The Rome IV criteria, published in 2016, represent an updated set of symptom-based diagnostic guidelines for functional gastrointestinal disorders (FGIDs) in children.
• Previous diagnostic criteria, such as Wessel's criteria for infant colic, have been revised or replaced.

Purpose of the Study:

• To evaluate the impact of the implementation of the Rome IV criteria on pediatric gastrointestinal practice.
• To analyze the changes in diagnostic criteria for FGIDs in neonates, toddlers, children, and adolescents.

Main Methods:

• Review of the Rome IV criteria and comparison with previous guidelines.
• Analysis of changes in diagnostic criteria for specific FGIDs including infant colic, functional constipation, functional dyspepsia, irritable bowel syndrome, and abdominal migraine.

Main Results:

• Wessel's criteria for infant colic were abandoned; new criteria differentiate functional constipation based on toilet training status.
• Functional dyspepsia is now the most common functional abdominal pain disorder, surpassing irritable bowel syndrome (IBS) due to revised diagnostic requirements.
• The diagnosis of abdominal migraine was narrowed, leading to a decrease in its reported prevalence.

Conclusions:

• The Rome IV criteria have significantly altered the diagnostic landscape for pediatric FGIDs.
• These changes impact the classification and prevalence of various functional gastrointestinal disorders in children.
• Further evaluation of clinical practice changes resulting from Rome IV implementation is warranted.