This document defines and categorizes various functional gastrointestinal disorders including: functional esophageal disorders (heartburn, chest pain, dysphagia, globus), functional gastroduodenal disorders (dyspepsia, belching disorders, nausea/vomiting), functional bowel disorders (irritable bowel syndrome, bloating, constipation, diarrhea), functional abdominal pain syndrome, functional gallbladder/sphincter of Oddi disorders, functional anorectal disorders (fecal incontinence, anorectal pain), and childhood functional GI disorders. It provides diagnostic criteria for each disorder.

1. Functional Esophageal Disorders
A1. Functional Heartburn C. Functional Bowel Disorders
A2. Functional Chest Pain of Presumed Esophageal Origin = NOT BURNING
C1. Irritable Bowel Syndrome = OMSET WITH CHANGE IN SHAPE /
A3. Functional Dysphagia = SENSE OF SOLID / LIQUID ABNORMAL PASSAGE
FREQUENCY OF STOOL – IMPROVEMENT WITH DEFECATION AT LEAST 3 DAYS / MONTH
A4. Globus = NON PAINFUL SENSE OF FOREIGN BODY TO THROAD BETWEEN MEALS
C2. Functional Bloating = FEELING OR VISIBLE DISTANTION AT LEAST 3
DAYS/ MONTH NO CRITERIA FOR F.DYSPEPSIA OR IRRITABLE BOWEL
B. Functional Gastroduodenal C3. Functional Constipation = AT LEASAT 25% OF DEFECATIONS IN A
Disorders
MONTH – LOOSE STOOL ONLY WITH LKAXATIVES – NO CRITERIA FRO IRRITABLE BOWEL
B1. FUNCTIONAL DYSPEPSIA = BOTHERSOME POSTPRANDIAL
– 3 DEFECATIONS A WEEK – MANUAL MANUVERS – LYMPY – STRAINING – INCOMPLETE
SATIATION OR FULNESS OR PAIN OR BURNING
EVACUATION SENSE
B1a. Postprandial Distress Syndrome = AFTEN 1 ORDINARY
C4. Functional Diarrhea = WATERLY / LOOSE 75 % OF DEFECATION WITH
SIZED MEAL – PREVENTS FINISGINH IT – MAY +NAYSEA / +BELCHING / +PAIN NO PAIN
C5. Unspecified Functional Bowel Disorder
– SEVERAL DAYS IN A WEEK
B1b. Epigastric Pain Syndrome = PAIN / BURNING [ NOT RETROSTERNAL ]
INTERMITTENTNT AT LEAST INCE IN A WEEK – NO GENERALIZED – NO LOCALIZED TO
OTHER REGIONS – NO BLUDDER / ODDO CRITERIA – NO RELIEF WITH DEFECATION – D. Functional Abdominal Pain
INDUCED OR RELIEF WITH MEAL – MAY AT FASTING PERIOD – MAY +POSTPRANDIAL
Syndrome
D. Functional Abdominal Pain Syndrome
DISTRESS
B2. BELCHING DISORDERS
B2a. Aerophagia
B2b. Unspecified Excessive Belching E. Functional Gallbladder and
Sphincter of Oddi Disorders
B3. NAUSEA AND VOMITING DISORDERS
E. Functional Gallbladder and Sphincter of Oddi Disorders
B3a. Chronic Idiopathic Nausea = MANY TIMES IN WEEK – USUALLY NO
= AT EPIGASTRIUM OR/AND RUQ – LASTS ½ HOUR OR MORE – NOT DAILY
ASOCIATION WITH VOMITING INNTERMITTENT - INTERUPTS ACTIVITIES – NIGIT WKE UP – NO CHANGE WITH
BOWL MOVEMENT / POSTURE CHANGE / ANTACIDS – ASOCCIATION WITH NAUSEA
B3b. Functional Vomiting
B3c. Cyclic Vomiting Syndrome / VOMIT – Radiates to the back and/or right infra subscapular region
= NO ACIDIC BUT PLEASANT TASTE - NOT
B4. Rumination Syndrome in Adults
E1. Functional Gallbladder Disorder = GALLBLADER PRESENT –
WITH NAUSEA – NOT AFTER RETCHING
Normal liver enzymes, conjugated bilirubin, and amylase/lipase
E2. Functional Biliary Sphincter of Oddi Disorder = Elevated serum
transaminases, alkaline phosphatase, or conjugated bilirubin AT
TWO EPISODES – NORMAL LIPASE / AMYLASE
E3. Functional Pancreatic Sphincter of Oddi Disorder = Elevated
amylase/lipase

2. F. Functional Anorectal Disorders H. Childhood Functional GI
Disorders: Child/Adolescent
F1. Functional Fecal Incontinence = Abnormal functioning of normally
H1. VOMITING AND AEROPHAGIA
innervated and structurally intact muscles – Normal or disordered bowel habits –
H1b. Cyclic Vomiting Syndrome
Psychological causes – Minor abnormalities of sphincter structure and/or innervation
H1c. Aerophagia
F2. FUNCTIONAL ANORECTAL PAIN H2. ABDOMINAL PAIN-RELATED FUNCTIONAL GI DISORDERS
H2a. Functional Dyspepsia
F2a. Chronic Proctalgia = RECTAL PAIN / ACHING – LASTS 20 miN / OR MORE – H2b. Irritable Bowel Syndrome
H2c. Abdominal Migraine
Exclusion of other causes of rectal pain such as ischemia, inflammatory bowel
H2d. Childhood Functional Abdominal Pain
H2d1. Childhood Functional Abdominal Pain Syndrome
disease, cryptitis, intramuscular abscess, anal fissure, hemorrhoids, prostatitis, and
H3. CONSTIPATION AND INCONTINENCE
coccygodynia H3a. Functional Constipation
H3b. Nonretentive Fecal Incontinence
F2a.1. Levator Ani Syndrome = Symptom criteria for chronic proctalgia and
tenderness during posterior traction on the puborectalis
F2a.2. Unspecified Functional Anorectal Pain = no tenderness during posterior
1. Absence of histopathology-based esophageal motility disorders
traction on the puborectalis
2. No evidence of structural disease
F2b. Proctalgia Fugax = Recurrent episodes of pain localized to the anus or lower
3. Absence of abnormalities at upper endoscopy or metabolic
rectum -- Episodes last from seconds to minutes -- There is no anorectal pain
disease that explains the SYMPTOM
between episodes 4. “Discomfort = uncomfortable sensation not described as pain
F3. Functional Defecation Disorders 5. Exclusion of other structural disease that would explain the
F3a. Dyssynergic Defecation = Inappropriate contraction of the pelvic floor or symptoms
less than 20% relaxation of basal resting sphincter pressure with adequate 6. Criteria fulfilled for the last 3 months
propulsive forces during attempted defecation 7. with symptom onset at least 6 months prior to diagnosis
F3b. Inadequate Defecatory Propulsion = Inadequate propulsive forces with
NO Abnormal innervation caused by lesion(s) within the brain (e.g.,
or without inappropriate contraction or less than 20% relaxation of the anal
dementia), spinal cord, or sacral nerve roots, or mixed lesions (e.g.,
multiple sclerosis), or as part of a generalized peripheral or autonomic
sphincter during attempted defecation neuropathy
(e.g., due to diabetes)
G. Childhood Functional GI Disorders: NO abnormalities associated with a multisystem disease
Infant/Toddler (e.g., scleroderma)
G1. Infant Regurgitation
G2. Infant Rumination Syndrome
G3. Cyclic Vomiting Syndrome
G4. Infant Colic
G5. Functional Diarrhea
G6. Infant Dyschezia
G7. Functional Constipation