Rome IV Diagnosis Criteria for Functional Heartburn
Official Rome IV criteria for the diagnosis of functional heartburn.
Use in patients with symptoms suggestive of functional heartburn, such as recurrent burning retrosternal discomfort or pain for at least 6 months, which is not responsive to antisecretory therapy.
Patients with any of the following features must be evaluated clinically for other diagnoses even though functional heartburn may be present:
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Symptoms suggestive of cardiac ischemia.
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Dysphagia.
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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 heartburn. Consider further assessment for other diseases, or a different functional GI disorder.
If meets diagnosis (positive):
Likely diagnosis of functional heartburn. Consider management as per current American Gastroenterological Association (AGA) Clinical Practice Update.
Management of functional heartburn may include:
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Tricyclic antidepressants (TCAs).
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Selective serotonin reuptake inhibitors (SSRIs).
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Serotonin noradrenergic reuptake inhibitors (SNRIs).
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Behavioral therapy (i.e. hypnosis).
Consult AGA guidelines for further details.
This calculator should only be used in patients who do not have signs or symptoms suggestive of a structural/mechanical, metabolic or systemic cause of their symptoms based on clinical history, physical exam and initial work-up. An esophageal pH study must show a normal amount of acid reflux and no symptom association with acid reflux.