title: Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III Criteria: results from a Norwegian prospective study.
abstract: 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.
authors.affiliation: Department of Child and Adolescent Psychiatry, Innlandet Hospital Trust, Gjøvik, Norway. helene.helgeland@sykehuset-innlandet.no
authors.forename: Helene
authors.initials: H
authors.lastname: Helgeland
authors.forename: Gro
authors.initials: G
authors.lastname: Flagstad
authors.forename: Jon
authors.initials: J
authors.lastname: Grøtta
authors.forename: Per Olav
authors.initials: PO
authors.lastname: Vandvik
authors.forename: Hanne
authors.initials: H
authors.lastname: Kristensen
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
mesh_terms: 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