Objectives: The updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria for various FGIDs. To our knowledge, the implications of these revisions for patient classification have not been identified. The purpose of this study was to compare classification results using Rome II versus Rome III criteria for FGIDs associated with chronic abdominal pain.
Patients and Methods: Participants were 368 pediatric patients whose subspecialty evaluations for chronic abdominal pain yielded no evidence of organic disease. The children's gastrointestinal symptoms were assessed with the parent-report version of the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS).
Results: More patients met the criteria for a pediatric pain-related FGID according to the Rome III criteria (86.6%) than the Rome II criteria (68.0%). In comparison with the results from the Rome II criteria, the Rome III criteria classified a greater percentage of children as meeting criteria for Abdominal Migraine (23.1% vs 5.7%) and Functional Abdominal Pain (11.4% vs 2.7%). Irritable Bowel Syndrome was the most common diagnosis according to both Rome II (44.0%) and Rome III (45.1%).
Conclusions: Changes to the Rome criteria make the Rome III criteria more inclusive, allowing classification of 86.6% of pediatric patients with medically unexplained chronic abdominal pain.
*Department of Pediatrics, Division of Adolescent Medicine and Behavioral Science, USA
†Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
Received 20 September, 2007
Accepted 5 February, 2008
Address correspondence and reprint requests to Lynn Walker, Division of Adolescent Medicine, Vanderbilt University Children's Hospital, Doctor's Office Tower 11128, 2200 Children's Way, Nashville, TN 37232-9060 (e-mail: firstname.lastname@example.org).
Supported by a grant to Dr. Walker from the National Institute of Child Health and Human Development (HD23264).