Rome IV-Kriteria Diagnostic Functional Dispepsia

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Rome IV 

Criteria for Functional Dyspepsia


B1. Functional dyspepsia*

Diagnostic criteria¶

1. One or more of the following:

a. Bothersome postprandial fullness

b. Bothersome early satiation

c. Bothersome epigastric pain

d. Bothersome epigastric burning

AND

2. No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms

B1a. Postprandial distress syndrome

Diagnostic criteria¶

Must include one or both of the following at least three days per week:

1. Bothersome postprandial fullness (ie, severe enough to impact on usual activities)

2. Bothersome early satiation (ie, severe enough to prevent finishing a regular-size meal)

No evidence of organic, systemic, or metabolic disease that is likely to explain the symptoms on routine investigations (including at upper
endoscopy)
Supportive remarks

 Postprandial epigastric pain or burning, epigastric bloating, excessive belching, and nausea can also be present

 Vomiting warrants consideration of another disorder

 Heartburn is not a dyspeptic symptom but may often coexist

 Symptoms that are relieved by evacuation of feces or gas should generally not be considered as part of dyspepsia

Other individual digestive symptoms or groups of symptoms, eg, from gastroesophageal reflux disease and the irritable bowel syndrome may
coexist with PDS

B1b. Epigastric pain syndrome

Diagnostic criteria¶

Must include at least one of the following symptoms at least one day a week:

1. Bothersome epigastric pain (ie, severe enough to impact on usual activities)

AND/OR

2. Bothersome epigastric burning (ie, severe enough to impact on usual activities)

No evidence of organic, systemic, or metabolic disease that is likely to explain the symptoms on routine investigations (including at upper
endoscopy)

Supportive remarks
1. Pain may be induced by ingestion of a meal, relieved by ingestion of a meal, or may occur while fasting

2. Postprandial epigastric bloating, belching, and nausea can also be present

3. Persistent vomiting likely suggests another disorder

4. Heartburn is not a dyspeptic symptom but may often coexist

5. The pain does not fulfill biliary pain criteria

6. Symptoms that are relieved by evacuation of feces or gas generally should not be considered as part of dyspepsia

Other digestive symptoms (such as from gastroesophageal reflux disease and the irritable bowel syndrome) may coexist with EPS
PDS: postprandial distress syndrome; EPS: epigastric pain syndrome.
* Must fulfill criteria for PDS and/or EPS.
¶ Criteria fulfilled for the last three months with symptom onset at least six months before diagnosis.

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