Rome IV Diagnostic Criteria for Infant Functional Diarrhea
Official Rome IV criteria for the diagnosis of infant functional diarrhea.
Use in otherwise healthy infants, toddlers and pre-school children with symptoms suggestive of functional diarrhea including daily painless diarrhea for at least 4 weeks.
Patients with any of the following alarm features should be evaluated clinically for other diagnoses:
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Weight loss.
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Failure to thrive.
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Abnormal growth.
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Abdominal pain or distension.
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Bloody stools.
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Respiratory symptoms.
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Abnormal perianal exam.
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Vomiting.
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Fever.
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Family history of celiac disease, pancreatitis, inflammatory bowel disease.
If diagnosis not met (negative):
Current symptoms are unlikely to be related to functional diarrhea. Consider further assessment as clinically indicated. Also, see pearls and pitfalls above.
If meets diagnosis (positive):
Likely diagnosis of functional diarrhea. Provide reassurance and consider conservative treatment recommendations.
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Treatment consists of reassurance and dietary advice.
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Reduce fructose, sorbitol, or high-osmolarity beverages.
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In children whose dietary fat is being restricted, fat intake should be normalized according to the recommended daily allowance for age.
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Other dietary restrictions are not indicated and should be avoided as they can result in unnecessary caloric and nutrient restriction with weight-loss.
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Symptoms are expected to self-resolve by school age.
This calculator should only be used in pediatric patients who do not have signs or symptoms suggestive of a structural/mechanical, metabolic, infectious, neurologic or systemic cause of their symptoms based on a detailed clinical history, physical exam and initial work-up.