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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.
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