Gut Liver.
2026 May;20(3):427-438. 10.5009/gnl250225.
Global Prevalence of Functional Abdominal Pain Disorder among Children and Adolescents According to the Rome III and IV Criteria: A Systematic Review and Meta-Analysis
- Affiliations
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- 1Department of Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
- 2Center for Digital Health, Medical Science Research Institute, College of Medicine, Kyung Hee University, Seoul, Korea
- 3Department of Precision Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
- 4Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
- 5Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Türkiye
- 6Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
- 7School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Korea
- 8Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- 9Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- 10Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- 11Department of Pediatrics, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea
- KMID: 2581080
- DOI: http://doi.org/10.5009/gnl250225
Abstract
- Background/Aims
Despite the global burden of functional abdominal pain disorder (FAPD) and its four subtypes (irritable bowel syndrome [IBS], functional dyspepsia [FD], abdominal migraine [AM], and functional abdominal pain not otherwise specified [FAP-NOS]), studies involving an estimation of FAPD prevalence based on the Rome III or IV criteria are limited. Therefore, we aimed to estimate the prevalence of FAPD and its four subtypes.
Methods
A comprehensive literature search was conducted in PubMed/MEDLINE, Embase, Google Scholar, and the Cochrane Library. Studies that were performed with the general population and applied Rome III or IV diagnostic criteria were included. Data were extracted to estimate the prevalence of FAPD using a random-effects model with 95% confidence intervals (CIs). Heterogeneity was assessed using the I 2 statistic. The study protocol was preregistered with PROSPERO (CRD420251004116).
Results
The overall prevalence of FAPD was 10.89% (95% CI, 9.51% to 12.48%), with pooled prevalence rates of 11.84% (10.29% to 13.61%) with the Rome III criteria and 8.42% (6.10% to 11.62%) with the Rome IV criteria. With the Rome III criteria, IBS had the highest prevalence, while FD had the lowest. In contrast, with the Rome IV criteria, the prevalence of IBS, AM, and FAP-NOS decreased, whereas FD became the most prevalent, affecting approximately one in 23 individuals, compared to one in 51 individuals affected by IBS, one in 68 individuals affected by AM, and one in 115 individuals affected by FAP-NOS. Additionally, females exhibited higher prevalence rates of FAPD and all its subtypes than males.
Conclusions
The diagnostic criteria of Rome IV are stricter than those of Rome III, which likely affects the estimated prevalence of FAPD and its subtypes.
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