Calculators & Tools

Rome IV — Abdominal Migraine

Paroxysmal episodes of intense periumbilical abdominal pain.

1 What is the Rome IV — Abdominal Migraine?

The Rome IV — Abdominal Migraine is a GI & Liver scoring tool used in paediatric practice. Paroxysmal episodes of intense periumbilical abdominal pain. It scores 6 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in GI & Liver
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 6 criteria: Paroxysmal episodes of intense, acute periumbilical, midline or diffuse abdominal pain lasting ≥ 1 hour; Episodes are separated by weeks to months; Pain is incapacitating and interferes with normal activities; Stereotypical pattern and symptoms in the individual patient; Pain associated with ≥2 of: anorexia, nausea, vomiting, headache, photophobia, pallor; Symptoms cannot be attributed to another condition after appropriate evaluation. Totals are then banded: any score - Criteria not met: all criteria must be fulfilled, occurring at least twice in the preceding 6 months; 6 criteria or more - Criteria met: all criteria met - abdominal migraine. Consider migraine-style prophylaxis and trigger avoidance; many children later develop typical migraine.
  • Source: Hyams JS et al. Rome IV - Functional disorders: children and adolescents. Gastroenterology 2016;150:1456-68.

4 Frequently asked questions

How many criteria does the Rome IV — Abdominal Migraine use?

6. They are Paroxysmal episodes of intense, acute periumbilical, midline or diffuse abdominal pain lasting ≥ 1 hour; Episodes are separated by weeks to months; Pain is incapacitating and interferes with normal activities; Stereotypical pattern and symptoms in the individual patient; Pain associated with ≥2 of: anorexia, nausea, vomiting, headache, photophobia, pallor; Symptoms cannot be attributed to another condition after appropriate evaluation.

What do the bands of the Rome IV — Abdominal Migraine mean?

The total is interpreted as: any score - Criteria not met: all criteria must be fulfilled, occurring at least twice in the preceding 6 months; 6 criteria or more - Criteria met: all criteria met - abdominal migraine. Consider migraine-style prophylaxis and trigger avoidance; many children later develop typical migraine.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Source: Hyams JS et al. Rome IV - Functional disorders: children and adolescents. Gastroenterology 2016;150:1456-68.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.