Rome V Pediatric Upper Gastrointestinal Disorders of Gut-Brain Interaction.

Upper gastrointestinal disorders of gut-brain interaction (DGBI) present from infancy through adolescence. The Rome V Criteria have expanded to include DGBI of the esophagus, disorders of air-transit, and feeding disorders, as well as rumination syndrome, cyclic vomiting, chronic nausea syndrome, and functional dyspepsia. This expansion provides a diagnostic framework for patients presenting with chest and throat pain, feeding difficulties, belching, pain with eating, nausea, and vomiting. Given the advances in impedance technology and high-resolution manometry, testing plays a greater role in many of these diagnostic criteria than they have in past Rome iterations. This harmony between symptoms and testing results in more precision in therapeutic approaches that are critically multidisciplinary. The ability to assign new, positive diagnoses across the upper gastrointestinal tract offers new opportunities for pediatric-focused therapeutic trials.