Rome V Pediatric Upper Gastrointestinal Disorders of Gut-Brain Interaction

Rachel Rosen1, Osvaldo Borelli2, Christophe Faure3

  • 1Center for Motility and Functional Gastrointestinal Disorders, Division of Gastroenterology, Children's Hospital Boston, Boston, Massachusetts.

Gastroenterology
|February 19, 2026
PubMed

Insights

The updated Rome V criteria now include more upper gastrointestinal Disorders of Gut-Brain Interaction (DGBI) in children. Advances in testing improve diagnosis and multidisciplinary treatment for pediatric DGBI.

Area of Science:

  • Pediatric Gastroenterology
  • Gut-Brain Interaction Research

Background:

  • Upper gastrointestinal Disorders of Gut-Brain Interaction (DGBI) affect individuals from infancy through adolescence.
  • The Rome V criteria represent an updated framework for diagnosing these conditions.

Purpose of the Study:

  • To outline the expanded scope of the Rome V criteria for pediatric upper gastrointestinal DGBI.
  • To highlight the role of advanced diagnostic testing in the updated criteria.
  • To emphasize the potential for improved, multidisciplinary therapeutic approaches.

Main Methods:

  • The study reviews the Rome V criteria, focusing on expanded diagnostic categories for pediatric upper gastrointestinal DGBI.
  • It discusses the integration of advanced diagnostic technologies like impedance and high-resolution manometry.
  • The framework considers symptoms such as chest/throat pain, feeding difficulties, belching, pain with eating, nausea, and vomiting.

Main Results:

  • The Rome V criteria now encompass esophageal DGBI, air-transit disorders, feeding disorders, rumination syndrome, cyclic vomiting, chronic nausea syndrome, and functional dyspepsia.
  • Increased reliance on impedance technology and high-resolution manometry enhances diagnostic precision.
  • The criteria facilitate precise, multidisciplinary therapeutic strategies.

Conclusions:

  • The expanded Rome V criteria provide a comprehensive diagnostic framework for pediatric upper gastrointestinal DGBI.
  • Integration of advanced testing improves diagnostic accuracy and therapeutic planning.
  • This offers new avenues for pediatric-specific clinical trials targeting DGBI.

Related Concept Videos

Physiology of Enteric Nervous System and Gut Health01:05

Physiology of Enteric Nervous System and Gut Health

The gastrointestinal tract, responsible for the digestion and absorption of nutrients, is safeguarded by the intestinal barrier, which consists of secretory, physical, and immune components. At the forefront is the secretory barrier, composed of essential elements such as mucus, gut microbiota, and defense proteins. They collaborate to break down food particles, facilitate nutrient absorption, and maintain optimal gut health. These secretory components ensure the smooth functioning of the...
1.6K
Enteric Nervous System: Regulation of GI Motor Activity01:11

Enteric Nervous System: Regulation of GI Motor Activity

The Enteric Nervous System (ENS) plays a pivotal role in regulating gastrointestinal or GI motor activity. This complex network of nerves, deeply embedded within the gut wall, responds to changes in the gut environment and receives input from both the autonomic nervous system and the central nervous system. By doing so, the ENS operates various programs tailored to the body's nutritional status and needs.
During periods of fasting, the ENS initiates the migrating myoelectric complex, a...
2.2K
Gastrointestinal Motility Disorders01:20

Gastrointestinal Motility Disorders

Gastrointestinal or GI motility disorders are characterized by irregular gastrointestinal tract movements, disrupting food transit from the mouth to the anus. They are caused by damage or dysfunction in gut muscles or nerves. These disorders can cause symptoms such as severe constipation, diarrhea, abdominal pain, and swallowing difficulties. Disorders can affect any segment of the GI tract and range widely in severity, from common conditions like GERD to life-threatening conditions like...
1.6K
Pathophysiology of Vomiting01:22

Pathophysiology of Vomiting

Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through...
4.6K
Gut-Brain Axis01:22

Gut-Brain Axis

The gut–brain axis is a bidirectional communication system that connects the gastrointestinal tract and the brain. This interaction is mediated through multiple pathways, including the vagus nerve, hormonal signals, immune responses, and chemical messengers produced by gut microbes.Microbial Contributions to Brain FunctionGut microbiota contributes significantly to brain function by producing neuroactive compounds. These include neuroactive compounds that influence neurotransmitters such...
249
Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
69