Functional Esophageal Disorders A1. Functional Heartburn

A2. Functional Chest Pain of Presumed Esophageal Origin = NOT BURNING

A3. Functional Dysphagia = SENSE OF SOLID / LIQUID ABNORMAL PASSAGE

A4. Globus = NON PAINFUL SENSE OF FOREIGN BODY TO THROAD BETWEEN MEALS

B. Functional Gastroduodenal Disorders B1. FUNCTIONAL DYSPEPSIA = BOTHERSOME POSTPRANDIAL

SATIATION OR FULNESS OR PAIN OR BURNING

B1a. Postprandial Distress Syndrome = AFTEN 1 ORDINARY

SIZED MEAL – PREVENTS FINISGINH IT – MAY +NAYSEA / +BELCHING / +PAIN

– SEVERAL DAYS IN A WEEK

B1b. Epigastric Pain Syndrome = PAIN / BURNING [ NOT RETROSTERNAL ]

INTERMITTENTNT AT LEAST INCE IN A WEEK – NO GENERALIZED – NO LOCALIZED TO

OTHER REGIONS – NO BLUDDER / ODDO CRITERIA – NO RELIEF WITH DEFECATION –

INDUCED OR RELIEF WITH MEAL – MAY AT FASTING PERIOD – MAY +POSTPRANDIAL

DISTRESS

B2. BELCHING DISORDERS B2a. Aerophagia

B2b. Unspecified Excessive Belching

B3. NAUSEA AND VOMITING DISORDERS

B3a. Chronic Idiopathic Nausea = MANY TIMES IN WEEK – USUALLY NO

ASOCIATION WITH VOMITING

B3b. Functional Vomiting

B3c. Cyclic Vomiting Syndrome

B4. Rumination Syndrome in Adults = NO ACIDIC BUT PLEASANT TASTE - NOT

WITH NAUSEA – NOT AFTER RETCHING

C. Functional Bowel Disorders C1. Irritable Bowel Syndrome = OMSET WITH CHANGE IN SHAPE /

FREQUENCY OF STOOL – IMPROVEMENT WITH DEFECATION AT LEAST 3 DAYS / MONTH

C2. Functional Bloating = FEELING OR VISIBLE DISTANTION AT LEAST 3

DAYS/ MONTH NO CRITERIA FOR F.DYSPEPSIA OR IRRITABLE BOWEL

C3. Functional Constipation = AT LEASAT 25% OF DEFECATIONS IN A

MONTH – LOOSE STOOL ONLY WITH LKAXATIVES – NO CRITERIA FRO IRRITABLE BOWEL

– 3 DEFECATIONS A WEEK – MANUAL MANUVERS – LYMPY – STRAINING – INCOMPLETE

EVACUATION SENSE

C4. Functional Diarrhea = WATERLY / LOOSE 75 % OF DEFECATION WITH

NO PAIN

C5. Unspecified Functional Bowel Disorder

D. Functional Abdominal Pain Syndrome

D. Functional Abdominal Pain Syndrome

E. Functional Gallbladder and Sphincter of Oddi Disorders

E. Functional Gallbladder and Sphincter of Oddi Disorders

= AT EPIGASTRIUM OR/AND RUQ – LASTS ½ HOUR OR MORE – NOT DAILY

INNTERMITTENT - INTERUPTS ACTIVITIES – NIGIT WKE UP – NO CHANGE WITH

BOWL MOVEMENT / POSTURE CHANGE / ANTACIDS – ASOCCIATION WITH NAUSEA

/ VOMIT – Radiates to the back and/or right infra subscapular region

E1. Functional Gallbladder Disorder = GALLBLADER PRESENT –

Normal liver enzymes, conjugated bilirubin, and amylase/lipase

E2. Functional Biliary Sphincter of Oddi Disorder = Elevated serum

transaminases, alkaline phosphatase, or conjugated bilirubin AT

TWO EPISODES – NORMAL LIPASE / AMYLASE

E3. Functional Pancreatic Sphincter of Oddi Disorder = Elevated

amylase/lipase

F. Functional Anorectal Disorders

F1. Functional Fecal Incontinence = Abnormal functioning of normally

innervated and structurally intact muscles – Normal or disordered bowel habits –

Psychological causes – Minor abnormalities of sphincter structure and/or innervation

F2. FUNCTIONAL ANORECTAL PAIN

F2a. Chronic Proctalgia = RECTAL PAIN / ACHING – LASTS 20 miN / OR MORE –

Exclusion of other causes of rectal pain such as ischemia, inflammatory bowel

disease, cryptitis, intramuscular abscess, anal fissure, hemorrhoids, prostatitis, and

coccygodynia

F2a.1. Levator Ani Syndrome = Symptom criteria for chronic proctalgia and

tenderness during posterior traction on the puborectalis

F2a.2. Unspecified Functional Anorectal Pain = no tenderness during posterior

traction on the puborectalis

F2b. Proctalgia Fugax = Recurrent episodes of pain localized to the anus or lower

rectum -- Episodes last from seconds to minutes -- There is no anorectal pain

between episodes

F3. Functional Defecation Disorders

F3a. Dyssynergic Defecation = Inappropriate contraction of the pelvic floor or

less than 20% relaxation of basal resting sphincter pressure with adequate

propulsive forces during attempted defecation

F3b. Inadequate Defecatory Propulsion = Inadequate propulsive forces with

or without inappropriate contraction or less than 20% relaxation of the anal

sphincter during attempted defecation

G. Childhood Functional GI Disorders: Infant/Toddler

G1. Infant Regurgitation

G2. Infant Rumination Syndrome

G3. Cyclic Vomiting Syndrome

G4. Infant Colic

G5. Functional Diarrhea

G6. Infant Dyschezia

G7. Functional Constipation

H. Childhood Functional GI

Disorders: Child/Adolescent H1. VOMITING AND AEROPHAGIA

H1b. Cyclic Vomiting Syndrome

H1c. Aerophagia

H2. ABDOMINAL PAIN-RELATED FUNCTIONAL GI DISORDERS

H2a. Functional Dyspepsia

H2b. Irritable Bowel Syndrome

H2c. Abdominal Migraine

H2d. Childhood Functional Abdominal Pain

H2d1. Childhood Functional Abdominal Pain Syndrome

H3. CONSTIPATION AND INCONTINENCE H3a. Functional Constipation

H3b. Nonretentive Fecal Incontinence

1. Absence of histopathology-based esophageal motility disorders

2. No evidence of structural disease

3. Absence of abnormalities at upper endoscopy or metabolic

disease that explains the SYMPTOM

4. “Discomfort = uncomfortable sensation not described as pain

5. Exclusion of other structural disease that would explain the

symptoms

6. Criteria fulfilled for the last 3 months

7. with symptom onset at least 6 months prior to diagnosis

NO Abnormal innervation caused by lesion(s) within the brain (e.g., dementia), spinal cord, or sacral nerve roots, or mixed lesions (e.g., multiple sclerosis), or as part of a generalized peripheral or autonomic neuropathy (e.g., due to diabetes)

NO abnormalities associated with a multisystem disease

(e.g., scleroderma)