Zeevenhooven Judith, Koppen Ilan J N, Benninga Marc A
Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Pediatr Gastroenterol Hepatol Nutr. 2017 Mar;20(1):1-13. doi: 10.5223/pghn.2017.20.1.1. Epub 2017 Mar 27.
Functional gastrointestinal disorders (FGIDs) are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on the symptom-based Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents. In this review, we discuss the novel Rome IV criteria for infants and toddlers. The criteria for infant colic were drastically changed, whereas only minor changes were made for regurgitation, cyclic vomiting syndrome, functional diarrhea, infant dyschezia and functional constipation. In addition to this, the new Rome IV discusses underlying mechanisms of pain in infants and toddlers, including the neuro-development of nociceptive and pain pathways, the various factors that are involved in pain experience, and methods of pain assessment in infants and toddlers is essential for the clinician who encounters functional pain in this age group. Overall, the Rome IV criteria have become more distinctive for all disorders in order to improve the process of diagnosing pediatric FGIDs.
功能性胃肠病（FGIDs）在全球范围内都很常见，涵盖了一系列归因于胃肠道但无法用结构或生化异常解释的疾病。这些疾病的诊断依赖于基于症状的罗马标准。2016年，罗马标准针对婴幼儿以及儿童和青少年进行了修订。在本综述中，我们讨论了针对婴幼儿的新罗马IV标准。婴儿腹绞痛的标准发生了巨大变化，而反流、周期性呕吐综合征、功能性腹泻、婴儿排便困难和功能性便秘仅做了微小改动。除此之外，新的罗马IV标准讨论了婴幼儿疼痛的潜在机制，包括伤害感受和疼痛通路的神经发育、疼痛体验中涉及的各种因素，以及婴幼儿疼痛评估方法，这对于在该年龄组遇到功能性疼痛的临床医生至关重要。总体而言，罗马IV标准对于所有疾病都变得更加独特，以改善儿科FGIDs的诊断过程。
