Plocek Anna, Wasowska-Królikowska Krystyna, Toporowska-Kowalska Ewa
Klinika Alergologii, Gastroenterologii i Zywienia Dzieci Uniwersytetu Medycznego w Łodzi.
Med Wieku Rozwoj. 2010 Oct-Dec;14(4):350-6.
The updated Rome III Classification of paediatric functional gastrointestinal disorders (FGIDs) associated with abdominal pain comprises: functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine, functional abdominal pain (FAP), functional abdominal pain syndrome (FAPS).
To assess the value of the Rome criteria in identifying FGIDs in children with chronic abdominal pain.
The study group consisted of 439 consecutive paediatric patients (192 boys and 247 girls) aged 4-18 years (mean age was 11.95 +/- 3.89 years) referred to the Paediatric Gastroenterology Department at Medical University of Lodz from January 2008 to June 2009 for evaluation of abdominal pain of at least 2 months' duration. After exclusion of organic disease children suspected of functional chronic abdominal pain were categorized with the use of Rome III criteria of FGIDs associated with abdominal pain (H2a-H2d1) and the Questionnaire on Paediatric Gastrointestinal Symptoms (with the permission of doctor L. S. Walker). The patients with known nonabdominal organic disease, chronic illness or handicap were excluded.
In 161 patients (36.58%) organic etiology was confirmed. Of the 278 children (63.42%) with functional chronic abdominal pain, 228 (82.02%) met the Rome III criteria for FGIDs associated with abdominal pain (FD, 15.5%; IBS, 21.6%; abdominal migraine, 5%; FAP 24.5%; FAPS, 15.9%). Fifty cases (17.98%) did not fulfill the criteria for subtypes of abdominal pain-related FGIDs--mainly due to different as defined by Rome III criteria (at least once per week) frequency of symptom presentation.
(1) In the authors'investigations FGIDs was the most frequent cause of chronic abdominal pain in children. (2) The significant number of children with nonclassified FGIDs implies the need to modify the diagnostic criteria of Rome III classification concerning the prevalence of symptoms.
最新的罗马III小儿功能性胃肠病（FGIDs）分类，与腹痛相关的包括：功能性消化不良（FD）、肠易激综合征（IBS）、腹型偏头痛、功能性腹痛（FAP）、功能性腹痛综合征（FAPS）。
评估罗马标准在识别慢性腹痛儿童功能性胃肠病中的价值。
研究组由2008年1月至2009年6月转诊至罗兹医科大学儿科胃肠病科的439例4至18岁（平均年龄11.95±3.89岁）的连续儿科患者组成（192名男孩和247名女孩），这些患者因持续至少2个月的腹痛前来评估。排除器质性疾病后，怀疑患有功能性慢性腹痛的儿童，根据与腹痛相关的功能性胃肠病罗马III标准（H2a - H2d1）以及儿科胃肠道症状问卷（经L.S.沃克医生许可）进行分类。已知患有非腹部器质性疾病、慢性病或残疾的患者被排除。
161例患者（36.58%）确诊为器质性病因。在278例功能性慢性腹痛儿童中（63.42%），228例（82.02%）符合与腹痛相关的功能性胃肠病罗马III标准（FD，15.5%；IBS，21.6%；腹型偏头痛，5%；FAP 24.5%；FAPS，15.9%）。50例（17.98%）不符合与腹痛相关的功能性胃肠病亚型标准，主要原因是症状出现频率不符合罗马III标准（每周至少一次）的定义。
（1）在作者的研究中，功能性胃肠病是儿童慢性腹痛最常见的原因。（2）大量未分类的功能性胃肠病儿童意味着需要修改罗马III分类中关于症状发生率的诊断标准。
