The diagnosis of a Functional Esophageal Disorder always presumes the absence of a structural or biochemical explanation for the symptoms.

A1. Globus

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. The persistent or intermittent sensation of a lump or foreign body in the throat;
2. Occurrence of the sensation between meals;
3. Absence of dysphagia and odynophagia; and
4. Absence of pathologic gastroesophageal reflux, achalasia, or other motility disorder with a recognized pathologic basis (e.g., scleroderma of the esophagus).

A2. Rumination Syndrome

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. Persistent or recurrent regurgitation of recently ingested food into the mouth with subsequent remastication and swallowing or spitting it out;
2. Absence of nausea and vomiting;
3. Cessation of the process when the regurgitated material becomes acidic; and
4. Absence of pathologic gastroesophageal reflux, achalasia, or other motility disorder with a recognized pathologic basis as the primary disorder.

A3. Functional Chest Pain of Presumed Esophageal Origin

At least 12 weeks, which need not be consecutive, within the preceding 12 months of:

1. Midline chest pain or discomfort that is not of burning quality; and
2. Absence of pathologic gastroesophageal reflux, achalasia, or other motility disorder with a recognized pathologic basis.

A4. Functional Heartburn

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. Burning retrosternal discomfort or pain; and
2. Absence of pathologic gastroesophageal reflux, achalasia, or other motility disorder with a recognized pathologic basis.

A5. Functional Dysphagia

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. Sense of solid and/or liquid foods sticking, lodging, or passing abnormally through the esophagus; and
2. Absence of pathologic gastroesophageal reflux, achalasia, or other motility disorder with a recognized pathologic basis.

A6. Unspecified Functional Esophageal Disorder

At least 12 weeks, which need not be consecutive, in the preceding 12 months of:

1. Unexplained symptoms attributed to the esophagus that do not fit into the previously described categories; and
2. Absence of pathologic gastroesophageal reflux, achalasia, or other motility disorder with a recognized pathologic basis.

References:

1. Douglas A. Drossman. ROME II: The Functional Gastrointestinal Disorders, Second Edition

This material was taken from the ROME II. It is intended for educational purposes only.

Created: March 19, 2005