Rome IV Diagnostic Criteria for Functional Dysphagia
Official Rome IV criteria for the diagnosis of functional dysphagia.
Use in patients with symptoms suggestive of functional dysphagia, such as a recurrent sense of solid and/or liquid foods passing abnormally through the esophagus, for at least 6 months.
Patients with any of the following features must be evaluated clinically for other diagnoses even though functional dysphagia may be present:
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Odynophagia.
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Sore throat.
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Heartburn or esophageal reflux/regurgitation.
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Unexplained iron deficiency anemia.
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Unintentional weight loss.
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Palpable cervical lymphadenopathy on exam.
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Persistent vomiting.
If diagnostic criteria are not met (negative):
Symptoms are unlikely to be caused by functional dysphagia. Consider further assessment for other diseases, or a different functional GI disorder.
If meets diagnosis (positive):
Likely diagnosis of functional dysphagia.
Management of functional dysphagia may include:
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Proton pump inhibitors to treat complications of GERD when present.
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Empiric endoscopic esophageal dilation for subtle esophageal ring or stricture which may explain the dysphagia symptoms.
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Neuromodulators (i.e. tricyclic antidepressants).
This calculator should only be used in patients after appropriate organic, systemic, and metabolic causes have been ruled out after careful investigation.