title: Functional dyspepsia--symptoms, definitions and validity of the Rome III criteria.
abstract: Dyspepsia refers to a heterogeneous group of symptoms that are localized in the epigastric region. Typical dyspeptic symptoms include postprandial fullness, early satiation, epigastric pain and epigastric burning, but other upper gastrointestinal symptoms such as nausea, belching or abdominal bloating often occur. Functional dyspepsia is defined as the presence of dyspeptic symptoms in the absence of an organic cause that readily explains them. The Rome III consensus proposed the subdivision of functional dyspepsia into postprandial distress syndrome (PDS), characterized by postprandial fullness and early satiation, and epigastric pain syndrome (EPS), characterized by epigastric pain or burning. Epidemiological studies in the USA and Europe confirmed the presence of both subgroups, with good separation between EPS and PDS. By contrast, other studies have found major overlap between EPS and PDS in patients with functional dyspepsia in specialist care centres in Europe and Asia. Preliminary pathophysiological studies suggest that PDS might be characterized by a higher prevalence of impaired gastric accommodation than EPS and raised duodenal eosinophil counts. Whether different treatment approaches are needed for EPS and PDS is currently unclear; only acotiamide, a new drug for the treatment of functional dyspepsia, has been found to be efficacious in PDS but not in EPS. Further randomized controlled trials testing treatment response by subgroup are urgently needed.
authors: TARGID (Translational Research Center for Gastrointestinal Disorders), University of Leuven, Herestraat 49, Leuven 3000, Belgium. jan.tack@med.kuleuven.be
authors: Jan
authors: J
authors: Tack
authors: Nicholas J
authors: NJ
authors: Talley
mesh_terms: D003937:Diagnosis, Differential; D019468:Disease Management; D004415:Dyspepsia / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D006356:Heartburn / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000503:physiopathology; D015203:Reproducibility of Results
references: J Clin Gastroenterol. 2009 Feb;43(2):118-22
references: 18719513
references: Neurogastroenterol Motil. 2010 Mar;22(3):262-e79
references: 19814775
references: Scand J Gastroenterol. 1998 Oct;33(10):1023-9
references: 9829354
references: Clin Gastroenterol Hepatol. 2005 Jun;3(6):543-52
references: 15952096
references: Digestion. 2009;79(2):65-72
references: 19246923
references: Am J Gastroenterol. 2010 Aug;105(8):1835-42
references: 20461070
references: Aliment Pharmacol Ther. 2009 Apr 1;29(7):765-73
references: 19183150
references: J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:46-8
references: 21443709
references: J Gastroenterol. 2011 Feb;46(2):183-90
references: 20957498
references: Am J Gastroenterol. 2004 Jun;99(6):1152-9
references: 15180740
references: Gastroenterology. 2006 Apr;130(5):1466-79
references: 16678560
references: BMC Gastroenterol. 2008 Sep 23;8:43
references: 18808723
references: Gastroenterology. 2009 Jul;137(1):94-100
references: 19328797
references: BMC Med Genet. 2010 Jan 26;11:13
references: 20102604
references: Neurogastroenterol Motil. 2012 Sep;24(9):821-7
references: 22616664
references: Gastroenterology. 2010 Apr;138(4):1302-11
references: 20074574
references: J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:75-8
references: 21443715
references: Lancet. 1988 Mar 12;1(8585):576-9
references: 2894503
references: J Neurogastroenterol Motil. 2010 Apr;16(2):148-56
references: 20535345
references: Am J Gastroenterol. 2008 Aug;103(8):2051-60
references: 18796099
references: Neurogastroenterol Motil. 2010 Jun;22(6):618-e173
references: 20059698
references: World J Gastroenterol. 2012 Aug 28;18(32):4379-85
references: 22969202
references: Am J Gastroenterol. 2001 May;96(5):1340-9
references: 11374666
references: J Clin Gastroenterol. 2004 Jul;38(6):490-5
references: 15220683
references: Neurogastroenterol Motil. 2012 Apr;24(4):325-e164
references: 22235936
references: Aliment Pharmacol Ther. 1993 Feb;7(1):81-6
references: 8439641
references: Gut. 2002 May;50 Suppl 4:iv10-2
references: 11953338
references: Am J Gastroenterol. 2010 Dec;105(12):2626-31
references: 20823838
references: Neurogastroenterol Motil. 2009 Mar;21(3):272-80
references: 19254354
references: Gut. 2002 May;50 Suppl 4:iv2-9
references: 11953337
references: Ultraschall Med. 2012 Dec;33(7):E233-E240
references: 23247728
references: Clin Gastroenterol Hepatol. 2007 Oct;5(10):1175-83
references: 17686660
references: Digestion. 2012;86(2):114-21
references: 22846371
references: Gut. 2012 Jun;61(6):821-8
references: 22157329
references: Am J Gastroenterol. 2007 Sep;102(9):1983-9
references: 17581264
references: Saudi J Gastroenterol. 2011 Mar-Apr;17(2):129-33
references: 21372351
references: Gastroenterology. 2006 Feb;130(2):296-303
references: 16472585
references: Scand J Gastroenterol. 1985 Mar;20(2):222-8
references: 3992181
references: Scand J Gastroenterol Suppl. 1999;231:48-54
references: 10565623
references: Gut. 2005 Oct;54(10):1370-6
references: 15972301
references: Arch Intern Med. 2011 Nov 28;171(21):1929-36
references: 22123802
references: Neurogastroenterol Motil. 2009 Apr;21(4):378-88
references: 19222761
references: J Gastroenterol. 2013 Jan;48(1):73-80
references: 22618805
references: Nat Rev Gastroenterol Hepatol. 2013 Mar;10(3):142-9
references: 23318268
references: Expert Opin Investig Drugs. 2011 May;20(5):701-12
references: 21417958
references: Neurogastroenterol Motil. 2011 Dec;23(12):1073-80
references: 21902766
references: Gastroenterology. 2004 Oct;127(4):1239-55
references: 15481001
references: Gut. 2008 Nov;57(11):1495-503
references: 18519430
references: Aliment Pharmacol Ther. 2006 Apr 1;23(7):923-36
references: 16573795
references: Clin Gastroenterol Hepatol. 2004 Nov;2(11):985-96
references: 15551251
references: Aliment Pharmacol Ther. 2004 Mar 15;19(6):643-54
references: 15023166
references: BMC Med Genet. 2011 Jun 29;12:88
references: 21714874
references: Neurogastroenterol Motil. 2005 Feb;17(1):29-34
references: 15670261
references: Gut. 2008 Dec;57(12):1666-73
references: 18625692