Biliary dyskinesia diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Overview

The Rome IV diagnostic criteria should be considered in patients with biliary pain and suspected motility disorders (functional gallbladder disorder and functional biliary sphincter of Oddi disorder).

Diagnostic Criteria

The Rome IV diagnostic criteria should be considered in patients with biliary pain and suspected motility disorders (functional gallbladder disorder and functional biliary sphincter of Oddi disorder):

Rome IV Diagnostic Criteria for Biliary Pain (Content from Cotton PB, Elta GH, Carter CR, et al. Gallbladder and sphincter of Oddi disorders. Gastroenterology 2016)
Diagnostic Criteria	Supportive criteria
Pain located in the epigastrium and/or right upper quadrant (RUQ) and all of the following: Builds up to a steady level and lasting 30 minutes or longer Occurring at different intervals (not daily) Severe enough to interrupt daily activities or lead to a visit to an emergency department Not significantly (<20%) related to bowel movements Not significantly (<20%) relieved by postural change or acid suppression	May be associated with: Nausea and vomiting Radiation to the back and/or right infrasubscapular Waking the patient from sleep

Rome IV Diagnostic Criteria for Functional Gallbladder Disorder and Functional Biliary Sphincter of Oddi Disorder (Content from Cotton PB, Elta GH, Carter CR, et al. Gallbladder and sphincter of Oddi disorders. Gastroenterology 2016)
Functional Gallbladder Disorder  (FGD)	Functional Biliary Sphincter of Oddi Disorder (SOD)
Diagnostic Criteria Criteria for biliary pain Absence of gallstones disease or other structural pathology   Supportive criteria   Low ejection fraction on gallbladder scintigraphy Normal liver enzymes, conjugated bilirubin, and amylase/lipase	Diagnostic Criteria Criteria for biliary pain Elevated liver enzymes or dilated bile duct, but not both Absence of bile duct stones or other structural abnormalities   Supportive criteria Normal amylase/lipase Abnormal sphincter of Oddi manometry HIDA scan