Calculators & Tools

Rome IV — Rumination Syndrome

Repeated regurgitation of recently ingested food, for ≥2 months.

1 What is the Rome IV — Rumination Syndrome?

The Rome IV — Rumination Syndrome is a GI & Liver scoring tool used in paediatric practice. Repeated regurgitation of recently ingested food, for ≥2 months. It scores 4 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 4 criteria: Repeated regurgitation and re-chewing or expulsion of food that begins soon after ingestion; Does NOT occur during sleep; Not preceded by retching; Not fully explained by another condition; an eating disorder has been excluded. Totals are then banded: any score - Criteria not met: all four criteria must be present for ≥2 months; 4 criteria or more - Criteria met: rome IV rumination syndrome. First-line treatment is diaphragmatic breathing training; behavioural therapy is effective.
  • 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 — Rumination Syndrome use?

4. They are Repeated regurgitation and re-chewing or expulsion of food that begins soon after ingestion; Does NOT occur during sleep; Not preceded by retching; Not fully explained by another condition; an eating disorder has been excluded.

What do the bands of the Rome IV — Rumination Syndrome mean?

The total is interpreted as: any score - Criteria not met: all four criteria must be present for ≥2 months; 4 criteria or more - Criteria met: rome IV rumination syndrome. First-line treatment is diaphragmatic breathing training; behavioural therapy is effective.

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.