Clinical characteristics of Japanese dyspeptic patients: is the Rome III classification applicable?
OBJECTIVE
While the Rome III classification seems logical, some aspects need further evaluation. The aim of this study was to evaluate the clinical characteristics of Japanese dyspeptic patients and to determine whether this classification could be applied to them.


METHODS
A total of 364 consecutive patients with a mean age of 54.5 years who had chronic symptoms occurring at least several times per week that could be attributed to the upper gastrointestinal tract were recruited. All of them underwent blood tests, ultrasonography, and endoscopy, which revealed no organic, systemic, or metabolic diseases. They also answered a questionnaire about their symptoms.


RESULTS
The subjects were divided into a postprandial distress symptom (PDS) group, epigastric pain symptom (EPS) group, and chronic idiopathic nausea symptom group. There was considerable overlap among these groups (109/198, 55.1%), and patients with non-erosive reflux disease accounted for 52.0% (103/198) of all subjects. The Rome III classification could not be applied to 62.7% of the PDS group and 61.3% of the EPS group because the onset of symptoms occurred less than 6 months before diagnosis (4.6 +/- 0.4 months for PDS and 4.6 +/- 0.5 months for EPS).


CONCLUSIONS
The current Rome III criteria for functional dyspepsia dose not adequately identify a large proportion of Japanese dyspeptic patients, primarily due to earlier presentation for medical evaluation. Therefore, the 6-month period after onset of dyspeptic symptoms should be shortened at least in the Japanese population experiencing dyspeptic symptoms.
Manabe
Noriaki
N
Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Matsushima, Kurashiki, Japan. n_manabe@hkg.odn.ne.jp
Haruma
Ken
K
Hata
Jiro
J
Imamura
Hiroshi
H
Kamada
Tomoari
T
Kusunoki
Hiroaki
H
Sanuki
Eiko
E
Tsumaru
Shuzo
S
Futagami
Yasuhiro
Y
Sadamoto
Yoshimi
Y
Tokutomi
Tadashi
T
Kurose
Hiromichi
H
D016009:Chi-Square Distribution; D002908:Chronic Disease; D004415:Dyspepsia / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D014463:Ultrasonography