Rome IV Diagnostic Criteria for Reflux Hypersensitivity
Official Rome IV criteria for the diagnosis of reflux hypersensitivity.
Use in patients with symptoms suggestive of reflux hypersensitivity, such as unexplained recurrent retrosternal symptoms (including heartburn and chest pain), for at least 6 months.
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 reflux hypersensitivity. Consider further assessment for other diseases, or a different functional GI disorder.
If meets diagnosis (positive):
Likely diagnosis of reflux hypersensitivity.
Management of reflux hypersensitivity may include:
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Proton pump inhibitors (PPIs) or high dose H2 antagonists.
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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).
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, which includes ambulatory pH monitoring.