The pediatric Rome IV criteria: what's new?

INTRODUCTION: Functional gastrointestinal disorders (FGIDs) are common in children of all ages and comprise of a wide range of conditions related to the gastrointestinal tract that cannot be attributed to structural or biochemical abnormalities. FGIDs are diagnosed according to the symptom-based Rome criteria. Areas covered: In 2016, the revised pediatric Rome IV criteria were published, these revised criteria are discussed in this review article. For the youngest age group (neonates/toddlers), the criteria for infant colic have undergone the most notable revisions. The most prominent changes in Rome IV were made in the criteria for children/adolescents, with the definition of two new FGIDs (functional nausea and functional vomiting) and the restructuring of the criteria for functional abdominal pain disorders, including the definition of FGID subtypes for functional dyspepsia and irritable bowel syndrome. Expert commentary: Overall, the Rome IV have been refined and are expected to improve the process of diagnosing FGIDs in the pediatric population and to better facilitate the healthcare professional in distinguishing different clinical entities. These changes will likely benefit future research and clinical care.