Gut 1999;45(Suppl 2):II60-II68 ( September )

Childhood functional gastrointestinal disorders

A Rasquin-Weber^a, P E Hyman^b, S Cucchiara^c, D R Fleisher^d, J S Hyams^e, P J Milla^f, A Staiano^g

^a Co-Chair, Committee on Childhood Functional Gastrointestinal Disorders, Multinational Working Teams to Develop Criteria for Functional Disorders (Rome II), Professor of Pediatrics, University of Montreal, Montreal, Canada, ^b Chair, Committee on Childhood Functional Gastrointestinal Disorders, Multinational Working Teams to Develop Criteria for Functional Disorders (Rome II), Associate Clinical Professor of Pediatrics, University of California at Los Angeles, Orange County, CA, USA, ^c Associate Professor of Pediatrics, University Frederico II, Naples, Italy, ^d Associate Professor of Child Health, University of Missouri, Columbia, MO, USA, ^e Professor and Vice Chair of Pediatrics, University of Connecticut School of Medicine, Hartford, CT, USA, ^f Reader in Pediatric Gastroenterology, University of London, London, UK, ^g Associate Professor of Pediatrics, University Frederico II, School of Medicine, Naples, Italy

Correspondence to: Andree Rasquin-Weber, MD, Gastrointestinal Division, Hopital Ste Justine, 3175 St Catherine Road, Montreal, Quebec H3T 1C5, Canada.

This is the first attempt at defining criteria for functional gastrointestinal disorders (FGIDs) in infancy, childhood, and adolescence. The decision-making process was as for adults and consisted of arriving at consensus, based on clinical experience. This paper is intended to be a quick reference. The classification system selected differs from the one used in the adult population in that it is organized according to main complaints instead of being organ-targeted. Because the child is still developing, some disorders such as toddler's diarrhea (or functional diarrhea) are linked to certain physiologic stages; others may result from behavioral responses to sphincter function acquisition such as fecal retention; others will only be recognizable after the child is cognitively mature enough to report the symptoms (e.g., dyspepsia). Infant regurgitation, rumination, and cyclic vomiting constitute the vomiting disorders. Abdominal pain disorders are classified as: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain, abdominal migraine, and aerophagia. Disorders of defecation include: infant dyschezia, functional constipation, functional fecal retention, and functional non-retentive fecal soiling. Some disorders, such as IBS and dyspepsia and functional abdominal pain, are exact replications of the adult criteria because there are enough data to confirm that they represent specific and similar disorders in pediatrics. Other disorders not included in the pediatric classification, such as functional biliary disorders, do occur in children; however, existing data are insufficient to warrant including them at the present time. For these disorders, it is suggested that, for the time being, clinicians refer to the criteria established for the adult population.


Keywords: infant vomiting; cyclic vomiting syndrome; functional dyspepsia in children; irritable bowel syndrome in children; functional abdominal pain in children; functional diarrhea in children; functional constipation in children; Rome II

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Aerophagia and abdominal migraine as childhood functional gastrointestinal disorders

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Gut Online, 31 Jan 2001 [Full text]