A Comparison Between Rome III and Rome IV Criteria in Children with Chronic Abdominal Pain: A Prospective...

Area of Science:

• Pediatric Gastroenterology
• Functional Gastrointestinal Disorders

Background:

• The Rome IV classification introduced redefined diagnostic criteria for functional gastrointestinal disorders.
• Previous classification systems like Rome III have been used for diagnosing these conditions.

Purpose of the Study:

• To compare diagnostic outcomes between Rome III and Rome IV criteria in pediatric patients with chronic abdominal pain.
• To identify specific diagnostic shifts in functional gastrointestinal disorders in children.

Main Methods:

• A prospective observational cohort study included 344 children with chronic abdominal pain (duration > 2 months) without organic disease.
• Patients were evaluated using both Rome III and Rome IV diagnostic criteria.

Main Results:

• Rome IV criteria did not significantly change the overall percentage of children diagnosed with functional abdominal pain disorders (89.8% vs. 89.2%, P > .05).
• The most common diagnoses were functional abdominal pain and functional abdominal pain syndrome (Rome III), shifting to functional abdominal pain, not otherwise specified (Rome IV).
• A notable diagnostic shift occurred, with an increase in functional dyspepsia and a decrease in irritable bowel syndrome diagnoses under Rome IV compared to Rome III.

Conclusions:

• Rome IV criteria maintain diagnostic prevalence but induce a shift in specific functional gastrointestinal disorder diagnoses in children with chronic abdominal pain.
• The reclassification under Rome IV led to some children previously diagnosed with irritable bowel syndrome being diagnosed with functional dyspepsia.