Rome III Criteria in Paediatric Functional Gastrointestinal Syndromes

The Rome III criteria can be used to diagnose functional abdominal issues/pain in children. It covers 5 syndromes:

1. Functional abdominal pain

2. Functional abdominal pain syndrome

3. Irritable Bowel Syndrome

4. Abdominal migraine

5. Cyclic vomiting syndrome

6. Functional diarrhea

Diagnostic criteria for Childhood Functional Abdominal Pain

Must include all of the following:

1. Episodic or continuous abdominal pain

2. Insufficient criteria for other functional GI disease

3. No evidence of an inflammatory, anatomic, metabolic or neoplastic process that explains the patients symptoms

Criteria must be fulfilled at least once per week for at least 2 months before diagnosis

Diagnostic criteria for Childhood Functional Abdominal Pain Syndrome

Must include functional abdominal pain at least 25% of the time and 1 or more of the following:

1. Some loss of daily functioning

2. Abdominal somatic symptoms such as headache, limb pain, or difficulty sleeping

Criteria must be fulfilled at least once per week for at least 2 months before diagnosis

Diagnostic criteria for Irritable bowel syndrome

Must include all of the following:

1. Abdominal discomfort (an uncomfortable sensation not described as pain) or pain associated with 2 or more of the following at least 25% of the time:

   1. Improve with defecation

   2. Onset associated with change in frequency of stool

   3. Onset associated with a change in form (appearance) of the stool

2. No evidence of an inflammatory, anatomic, metabolic or neoplastic process that explains the patients symptoms

Criteria must be fulfilled at least once per week for at least 2 months before diagnosis

Diagnostic criteria for Abdominal Migraine

Must include all of the following:

1. Paroxysmal episodes of intense, acute, periumbilical pain that lasts for 1 hour or more

2. Intervening periods of usual health lasting weeks to months

3. The pain interferes with normal activities

4. The pain is associated with 2 or more of the following:

   1. Anorexia

   2. Nausea

   3. Vomiting

   4. Headache

   5. Photophobia

   6. Pallor

5. No evidence of an inflammatory, anatomic, metabolic or neoplastic process that explains the patients symptoms

Criteria must be fulfilled 2 or more times in the preceding 12 months for diagnosis

Diagnostic criteria for Cyclic Vomiting Syndrome

Must include all of the following:

1. Two or more periods of intense nausea and unremitting vomiting or retching lasting hours to days

2. Return to usual state of health lasting weeks to months

Diagnostic criteria for Functional Diarrhea

Must include all of the following:

1. Daily painless, recurrent passage of three or more large, unformed stools

2. Symptoms > 4 weeks

3. Onset of symptoms that begins between 6 and 36 months of age

4. Passage of stools that occur during waking hours

5. There is no failure to thrive if caloric intake is adequate