Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III Criteria: results from a Norwegian prospective study

J Pediatr Gastroenterol Nutr. 2009 Sep;49(3):309-15. doi: 10.1097/MPG.0b013e31818de3ab.


Objectives: 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.

Materials and 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Abdominal Pain / etiology*
  • Adolescent
  • Aerophagy / diagnosis*
  • Aerophagy / epidemiology
  • Child
  • Child, Preschool
  • Diagnostic Techniques, Digestive System*
  • Humans
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / diagnosis*
  • Irritable Bowel Syndrome / epidemiology
  • Migraine Disorders / diagnosis*
  • Migraine Disorders / epidemiology
  • Norway
  • Prevalence
  • Prospective Studies
  • Reference Values
  • Reproducibility of Results
  • Surveys and Questionnaires