The document outlines diagnostic criteria for various functional gastrointestinal disorders in infants and children according to the Rome III criteria. It describes criteria for infant regurgitation, rumination syndrome, cyclic vomiting syndrome, infant colic, functional diarrhea, infant dyschezia, and functional constipation which include symptoms such as frequency of vomiting, crying, stool characteristics and patterns, straining, and pain levels. The criteria establish guidelines for diagnosing several common gastrointestinal issues in infants and children.

1. Functional Gastrointestinal
Disorders
Rome III diagnostic Criteria

2. Functional Gastrointestinal Disorders
• Infant regurgitation
• Infant rumination syndrome
• Cyclic vomiting syndrome
• Infant colic
• Functional diarrhea
• Infant dyschezia
• Functional constipation

3. Infant Regurgitation
• BOTH, 3 weeks – 12 months
• Regurgitation ≥ 2 times/day for ≥ 3 weeks
• Retching
• Hematemesis
• Aspiration
• Apnea
• Failure to thrive
• Feeding or swallowing difficulties
• Abnormal posturing

4. Infant Regurgitation
0
20
40
80
N=948

5. Infant rumination syndrome
• ALL, ≥ 3 months
• Contractions of abdominal muscles, diaphragm, tongue
• Regurgitation of gastric content into mouth
rechewed and reswallowed
• ≥ 3 following
• Onset: 3 – 8 months
• NOT respond to management (GERD, anticholinergic
drug, hand restraints, fomula changes, gavage or
gastrotomy feedings)
• NOT nausea or distress
• NOT when sleep, interacting

6. Cyclic vomiting Syndrome
• BOTH
• ≥ 2 periods of intense nausea and unremitting
vomiting or retching lasting for hours to days
• Return to usual state of health lasting weeks
to months

7. Cyclic vomiting Syndrome

8. Infant colic
• ALL, birth – 4 months
• Paroxysms of irritability, fussing or crying that
starts and stops without obvious cause
• Episodes lasting ≥ 3 hrs/day, ≥ 3 days/week for
at least 1 week
• No failure to thrive

10. Functional diarrhea
• ALL
• Daily painless, recurrent passage of ≥ 3 large,
unformed stool
• ≥ 4 weeks
• Onset: 6 – 36 months of age
• Passage stools during waking hours
• No failure to thrive

12. Infant dyschezia
• BOTH, < 6 months of age
• ≥ 10 minutes of straining and crying before
passage soft stool
• No other health problems

13. Functional constipation
• ≥ 2 followings, ≥ 1month
• ≤ 2 defecations/week
• ≥ 1 episode/week of incontinence after the acquisition
of toileting skills
• History of excess stool retention
• History of painful or hard bowel movements
• Presence of a large fecal mass in the rectum
• History of large diameter stools (obstruct the toilet)

15. Summary