Journal of Clinical Pediatrics ›› 2026, Vol. 44 ›› Issue (7): 595-608.doi: 10.12372/jcp.2026.26e0787

• Standard · Protocol · Guideline •     Next Articles

Core interpretation and explanation of Rome Ⅴ diagnostic criteria: upper gastrointestinal disorders of gut-brain interaction in children and adolescents

Rachel Rosen1, Osvaldo Borrelli2, Christophe Faure3, Katja Karrento4, Usha Krishnan5,6, Samuel Nurko1, Nathalie Rommel7,8, Alan Silverman9, Michiel van Wijk10,11, Marc Benninga (Author)10, Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator)   

  1. 1Center for Motility and Functional Gastrointestinal Disorders, Division of Gastroenterology, Children’s Hospital Boston, Boston, Massachusetts
    2Department of Pediatric Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London, United Kingdom
    3Division of Pediatric Gastroenterology, H?pital Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
    4Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin
    5School of Clinical Medicine, Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, Australia
    6Department of Pediatric Gastroenterology, Sydney Children’s Hospital, Randwick, Sydney, New South Wales, Australia
    7Department of Gastroenterology, Neurogastroenterology and Motility, University Hospitals Leuven, Leuven, Belgium
    8Department of Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium
    9Department of Pediatrics, Division of Pediatric Psychology & Developmental Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
    10Department of Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands
    11Amsterdam Gastroenterology Endocrinology Metabolism & Amsterdam Reproduction and Development Research Institutes, Amsterdam UMC, VU University, Amsterdam, the Netherlands
  • Received:2026-06-10 Revised:2026-06-23 Accepted:2026-06-30 Published:2026-07-15 Online:2026-07-12

Abstract:

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.

Key words: feeding disorders, gastroesophageal reflux, neuromodulators, child

CLC Number: 

  • R72