Rome IV Criteria for diagnosing Functional Abdominal Pain Disorders (FAPD)

Irritable bowel syndrome

The criteria must be fulfilled for at least 2 months and include all of the following:

 • Abdominal pain at least 4 days per month associated with defaecation and/or a change in the frequency of stool and/or a change in the appearance of stool

 • Abdominal pain does not resolve with resolution of the constipation (children in whom the pain resolves have functional constipation, not irritable bowel syndrome)

 • After appropriate evaluation, the symptoms cannot be fully explained by another medical condition

Functional dyspepsia

The criteria must be fulfilled for at least 2 months before diagnosis and must include one or more of the following bothersome symptoms at least 4 days per month:

 • Postprandial fullness

 • Early satiation

 • Epigastric pain or burning not associated with defaecation

 • After appropriate evaluation, the symptoms cannot be fully explained by another medical condition

Abdominal migraine

The criteria must be fulfilled for at least 6 months before diagnosis and include all of

the following occurring at least twice:

 • Paroxysmal episodes of intense, acute periumbilical, midline or diffuse abdominal pain lasting 1 hour or more (should be the most severe and distressing symptom) 

 • Episodes are separated by weeks to months; the pain is incapacitating and interferes with normal activities; stereotypical pattern and symptoms in the individual patient

 • The pain is associated with two or more of the following: anorexia, nausea, vomiting, headache, photophobia or pallor 

 • After appropriate evaluation, the symptoms cannot be fully explained by another medical condition

Functional abdominal pain not otherwise specified

The criterial must be fulfilled for at least 2 months before diagnosis and at least four times per month and include all of the following:

 • Episodic or continuous abdominal pain that does not occur solely during physiological events (for example, eating and menses)

 • Insufficient criteria for irritable bowel syndrome, functional dyspepsia or abdominal migraine

 • After appropriate evaluation, the abdominal pain cannot be fully explained by another medical condition



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