Childhood functional gastrointestinal disorders

This is the first attempt at defining criteria for functional gastrointesti nal disorders (FGIDs) in infancy, childhood, and adolescence. The decision- making process was as for adults and consisted of arriving at consensus, ba sed on clinical experience. This paper is intended to be a quick reference. The classification system selected differs from the one used in the adult population in that it is organized according to main complaints instead of being organ-targeted. Because the child is still developing, some disorders such as toddler's diarrhea (or functional diarrhea) are linked to certain physiologic stages; others may result from behavioral responses to sphincte r function acquisition such as fecal retention; others will only be recogni zable after the child is cognitively mature enough to report the symptoms ( e.g., dyspepsia). Infant regurgitation, rumination, and cyclic vomiting con stitute the vomiting disorders. Abdominal pain disorders are classified as: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain, abdominal migraine, and aerophagia. Disorders of defecation include: infant dyschezia, functional constipation, functional fecal retention, and functional nonretentive fecal soiling. Some disorders, such as IBS and dys pepsia and functional abdominal pain, are exact replications of the adult c riteria because there are enough data to confirm that they represent specif ic and similar disorders in pediatrics. Other disorders not included in the pediatric classification, such as functional biliary disorders, do occur i n children; however, existing data are insufficient to warrant including th em at the present time. For these disorders, it is suggested that, for the time being, clinicians refer to the criteria established for the adult popu lation.