title: Predominant symptoms identify different subgroups in functional dyspepsia.
abstract: OBJECTIVE
  Dyspepsia is a common syndrome that often defies diagnosis. Whether the unexplained (or "functional") dyspepsia represents a homogeneous syndrome or includes different subgroups with specific clinical features has not been clarified. The aim of this study was to investigate the relationship between symptom severity, demographic features, and gastric dysmotility in a large series of patients with functional dyspepsia.
  
  
  METHODS
  Severity of individual digestive symptoms, demographic features, and scintigraphic gastric emptying of solids were evaluated in 483 patients with chronic unexplained dyspepsia.
  
  
  RESULTS
  Two main subgroups were identified. The first was characterized by predominant epigastric pain, male gender (61%), and normal gastric emptying. The second subgroup was characterized by predominant nonpainful symptoms, female gender (60%), a high frequency of associated irritable bowel syndrome (30%), and delayed gastric emptying (42%). A third group included approximately one-third of patients who did not present with any predominant symptom, and was characterized by a high frequency of delayed gastric emptying (30%), overlapping irritable bowel syndrome (28%), and gastroesophageal reflux disease (41%).
  
  
  CONCLUSIONS
  Different subgroups exist among patients with functional dyspepsia seen in a referral center. They can be identified by the predominant symptom and are characterized by different demographic, clinical, and pathophysiological features.
authors.affiliation: Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Stanghellini
authors.forename: C
authors.initials: C
authors.lastname: Tosetti
authors.forename: A
authors.initials: A
authors.lastname: Paternicò
authors.forename: R
authors.initials: R
authors.lastname: De Giorgio
authors.forename: G
authors.initials: G
authors.lastname: Barbara
authors.forename: B
authors.initials: B
authors.lastname: Salvioli
authors.forename: R
authors.initials: R
authors.lastname: Corinaldesi
mesh_terms: D000328:Adult; D000368:Aged; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004415:Dyspepsia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology; D012307:Risk Factors; D013270:Stomach / Q000503:physiopathology