Functional dyspepsia: not all roads seem to lead to rome.
BACKGROUND
The Rome criteria have been introduced to create order in the heterogeneity of functional dyspepsia. The applicability of these symptom-based classification systems remains controversial.


OBJECTIVE
To evaluate the successive Rome criteria for functional dyspepsia in a large pool of patients with endoscopically verified functional dyspepsia.


METHODS
Patients referred to a secondary care district hospital were asked to fill out a questionnaire on gastrointestinal symptoms 2 weeks before upper gastrointestinal endoscopy. Patients were classified according to the Rome I, II, and III criteria for functional dyspepsia.


RESULTS
Nine hundred and twelve (70%) patients had no organic disorder explaining their symptoms. According to the Rome I, II, and III criteria, 371 (41%), 735 (81%), and 551 (60%) of these patients had functional dyspepsia, respectively. Twenty-five percent of patients had functional dyspepsia according to all 3 Rome criteria, whereas 15% was not classifiable at all. Forty-four percent and 42% of the patients, respectively, had epigastric pain syndrome and postprandial distress syndrome according to the Rome III criteria; however, 26% of all patients met both criteria and 40% was not classified at all.


CONCLUSIONS
The symptom-based Rome classification of functional dyspepsia does not lead to an easily applicable and consistent system that is useful in clinical practice or scientific research.
van Kerkhoven
Lieke A S
LA
Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. l.vankerkhoven@gmail.com
Laheij
Robert J F
RJ
Meineche-Schmidt
Villy
V
Veldhuyzen-van Zanten
Sander J
SJ
de Wit
Niek J
NJ
Jansen
Jan B M J
JB
D000328:Adult; D000368:Aged; D004415:Dyspepsia / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000145:classification / Q000150:complications* / Q000175:diagnosis; D041981:Gastrointestinal Tract / Q000473:pathology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires