Diagnostic Outcome of Rome IV Criteria in Diagnosis of Functional Constipation among Infants and Children

Abstract Background Functional Constipation is one of the most prevalent functional gastrointestinal disorders (FGIDs) among children worldwide. Rome IV criteria is used to diagnose functional constipation. The use of Rome questionnaire for screening also reveals other associated FGIDs. Objective To assess the outcome of Rome IV criteria in diagnosis of functional constipation among infants and children and follow up of cases to uncover any organic causes among them. Methods Cross-sectional, controlled study on 121 patients diagnosed as constipation with no red flags, selected from Pediatric Gastroenterology & General Clinics in Ain Shams University, Egypt. Patients were divided into 2 groups, below 4 years old (21 patients) and above 4 years old (100 patients) based upon the age stratification of the Rome criteria which was applied to all patients. Results There was nearly equal gender affection with a median age of 10 months among patients younger than 4 years, and a median age of 7 years old among patients older than 4 years. It was found that 38.1% of infants had a mixed diagnosis, where infant colic and regurgitation occurred in 9.5% and 33.3% of cases respectively. While among the group above 4 years old, Functional Dyspepsia represented the most common associated FGID (64%), followed by Aerophagia (8%), then Functional Vomiting (5%), while Abdominal Migraine and Functional Nausea represented 3% and 1% of all cases respectively. Upon follow up none of the patients developed any organic disease. Conclusion We concluded that diagnosis and follow up of patients using Rome IV is efficient in excluding organic diseases and diagnosing functional constipation (FC) and it avoids the need for further investigations. Moreover, Rome questionnaire was able to detect other FGIDs associated with constipation.