How to use Rome IV criteria in the evaluation of esophageal disorders

In this report, the Rome IV criteria for esophageal DGBI, the updated algorithms for esophageal symptoms, and the multidimensional clinical profile (MDCP) are reviewed. Summary The esophageal DGBI comprise functional esophageal chest pain, functional heartburn, globus, functional dysphagia, and the newly introduced reflux hypersensitivity. They are characterized by the presence of chronic symptoms attributed to the esophagus without evidence of esophageal structural, inflammatory, or motility abnormalities. Also, Rome IV suggests for the first time the possibility that functional heartburn or reflux hypersensitivity might overlap with gastroesophageal reflux disease. Accordingly, testing with endoscopy and biopsies, esophageal pH ± impedance monitoring and high-resolution esophageal manometry are necessary to establish esophageal DGBI diagnoses. Algorithms aid in this diagnostic process, and the MDCP that captures the full dimension of each patient's presentation is helpful in planning personalized treatment regimens.
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research