Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III Criteria: results from a Norwegian prospective study.
OBJECTIVE
To determine the proportion of referred children with nonorganic abdominal pain who meet the criteria for 1 or more diagnoses of functional gastrointestinal disorders (FGID), explore the distribution of diagnoses according to the revised pediatric Rome III criteria (PRC-III), and to investigate reasons for failure to meet these criteria.


METHODS
We recruited children (4-15 years) consecutively referred by general practitioners to 4 general pediatric outpatient clinics for the evaluation of recurrent abdominal pain. FGID diagnoses were based on the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version, completed by parents. To exclude organic disease, all patients underwent medical investigations and were reevaluated at follow-up after 6 to 9 months.


RESULTS
Of the 152 patients included, 142 (93%) had functional abdominal pain. Of these, 124 (87%) met the criteria for 1 or more diagnoses according to the PRC-III: 66% met the criteria for 1, 29% for 2, and 5% for 3 diagnoses. Irritable bowel syndrome was the most common diagnosis (43%) and overlapped with aerophagia in 16 children (38% of the children with overlapping diagnoses) and with abdominal migraine in 14 (33%). In the 18 patients (13%) not fulfilling the PRC-III for any FGID diagnosis, the main reason was insufficient pain frequency (83%).


CONCLUSIONS
Of the referred children with functional abdominal pain, 87% met the PRC-III for specific diagnoses. This supports the use of these criteria as a diagnostic tool. The significant overlap between different FGIDs, however, makes it unclear whether some of the diagnoses represent distinct disorders or artificial categories.
Helgeland
Helene
H
Department of Child and Adolescent Psychiatry, Innlandet Hospital Trust, Gjøvik, Norway. helene.helgeland@sykehuset-innlandet.no
Flagstad
Gro
G
Grøtta
Jon
J
Vandvik
Per Olav
PO
Kristensen
Hanne
H
Markestad
Trond
T
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000334:Aerophagy / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003938:Diagnostic Techniques, Digestive System; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009664:Norway; D015995:Prevalence; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires