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Rome IV Diagnostic Criteria for Biliary Pain
Defines biliary-type pain for work-up of gallbladder/sphincter of Oddi disorders.
Rome IV Diagnostic Criteria for Biliary Pain
Pain located in the epigastrium and/or right upper quadrant
Pain builds up to a steady level and lasts 30 minutes or longer
Pain occurs at different intervals, not daily
Pain is severe enough to interrupt daily activities or lead to an emergency department visit
Pain is not significantly (<20%) related to bowel movements
Pain is not significantly (<20%) relieved by postural change or acid suppression
ResultCriteria not met
Symptom pattern does not fulfil all required Rome diagnostic criteria for biliary pain; consider alternative diagnoses or further evaluation.
When to use
- Characterising suspected biliary-type pain before imaging/functional work-up for functional gallbladder or sphincter of Oddi disorders.
Formula
All required: pain in epigastrium and/or RUQ that builds to a steady level lasting >=30 minutes, occurring at different (non-daily) intervals, severe enough to interrupt activities or prompt an ED visit, not significantly related to bowel movements, and not significantly relieved by postural change or acid suppression.
Pearls and pitfalls
- Pain may be associated with nausea/vomiting, radiation to the back or right infrascapular region, or waking the patient from sleep — these are supportive, not required, features.