ToolsCalculators
Rome IV Diagnosis Criteria for Functional Heartburn
Diagnoses functional heartburn once reflux and motor disorders are excluded.
Rome IV Diagnosis Criteria for Functional Heartburn
Burning retrosternal discomfort or pain
No symptom relief despite optimal antisecretory (PPI) therapy
Absence of evidence that GERD or eosinophilic esophagitis is the cause of the symptom
Absence of a major esophageal motor disorder (achalasia, EGJ outflow obstruction, diffuse esophageal spasm, jackhammer esophagus, absent peristalsis)
Criteria fulfilled for the last 3 months, with symptom onset at least 6 months before diagnosis, occurring at least twice a week
ResultCriteria not met
Symptom pattern does not fulfil all required Rome diagnostic criteria for functional heartburn; consider alternative diagnoses or further evaluation.
When to use
- Diagnosing functional heartburn in patients with typical heartburn who have normal endoscopy/pH testing and no response to acid suppression.
Formula
All required: burning retrosternal discomfort/pain; no relief with optimal antisecretory therapy; GERD and eosinophilic esophagitis excluded as cause; no major esophageal motor disorder; symptoms for the last 3 months, onset >=6 months prior, frequency >=2x/week.
Pearls and pitfalls
- Requires prior objective exclusion of GERD (normal endoscopy/pH-impedance testing), not just failure to respond to PPIs.