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Rome IV Diagnostic Criteria for Child Abdominal Migraine

Diagnoses abdominal migraine in children and adolescents.

Rome IV Diagnostic Criteria for Child Abdominal Migraine
Two or more paroxysmal episodes of intense, acute periumbilical, midline, or diffuse abdominal pain lasting 1 hour or more (the most severe/distressing symptom)
Episodes are separated by weeks to months
The pain is incapacitating and interferes with normal activities
Stereotypical pattern and symptoms in this individual patient
Associated with anorexia
Associated with nausea
Associated with vomiting
Associated with headache
Associated with photophobia
Associated with pallor
After appropriate evaluation, symptoms cannot be fully explained by another medical condition
Criteria fulfilled for at least 6 months prior to diagnosis
ResultCriteria not met

Symptom pattern does not fulfil all required Rome diagnostic criteria for abdominal migraine; consider alternative diagnoses or further evaluation.

Associated symptoms present
0 of 6 (need >=2)

When to use

  • Diagnosing abdominal migraine in a child or adolescent with recurrent, incapacitating episodic abdominal pain and associated migrainous features.

Formula

Must include all of: >=2 paroxysmal episodes of intense periumbilical/midline/diffuse pain lasting >=1 hour; episodes separated by weeks-months; pain is incapacitating; stereotypical pattern; pain associated with >=2 of anorexia, nausea, vomiting, headache, photophobia, pallor; not explained by another condition. Criteria met for >=6 months.

Pearls and pitfalls

  • A personal or family history of migraine headache supports the diagnosis but is not a required criterion.

References

  1. Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150(6):1257-1261.