How to use Rome IV criteria in the evaluation of esophageal disorders

Current Opinion in Gastroenterology
Max J Schmulson

Abstract

In 2016, the Rome IV process and criteria were published. They provide a system to standardize patient diagnostic requirements for clinical studies and pharmaceutical trials on functional gastrointestinal disorders (FGIDs), which are now called disorders of gut-brain interaction (DGBI). Although the Rome criteria have limitations in clinical practice, an understanding of the criteria can help clinicians to manage symptoms in patients with DGBI, and with organic diseases as well. In this report, the Rome IV criteria for esophageal DGBI, the updated algorithms for esophageal symptoms, and the multidimensional clinical profile (MDCP) are reviewed. The esophageal DGBI comprise functional esophageal chest pain, functional heartburn, globus, functional dysphagia, and the newly introduced reflux hypersensitivity. They are characterized by the presence of chronic symptoms attributed to the esophagus without evidence of esophageal structural, inflammatory, or motility abnormalities. Also, Rome IV suggests for the first time the possibility that functional heartburn or reflux hypersensitivity might overlap with gastroesophageal reflux disease. Accordingly, testing with endoscopy and biopsies, esophageal pH ± impedance monitoring and high...Continue Reading

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Citations

Oct 8, 2019·Journal of Neurogastroenterology and Motility·Ronnie FassJose Tawil
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Jul 10, 2021·World Journal of Gastroenterology : WJG·Mihaela Fadgyas StanculeteStefan-Lucian Popa

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Methods Mentioned

BETA
biopsies

Software Mentioned

Rome IV Interactive Clinical Decision Toolkit

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