Rome IV Criteria Get Specific about Functional Gastroduodenal Disorders

MAY 23, 2016
Katherine Hasal
“Symptoms that can be attributed to the gastroduodenal region represent one of the main subgroups of functional gastrointestinal disorders affecting about 20% of the world’s population,” said Nicholas Talley, MD, PhD, of the University of Newcastle, Australia, at a presentation at Digestive Disease Week 2016, a joint meeting of the American Academy for the Study of Liver Diseases (AASLD), American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
Talley provided an overview of the slightly modified four categories of gastroduodenal disorders. First, functional dyspepsia, which affects an estimated 10% to 30% of people worldwide, is characterized by one or more the following: postprandial fullness, early satiation, epigastric pain, and epigastric burning, which are unexplained after a routine clinical evaluation. The functional dyspepsia category includes two subcategories: postprandial distress syndrome (PDS) characterized by meal-induced dyspeptic symptoms, and epigastric pain syndrome (EPS) that does not occur exclusively postprandially.
The updates to the Rome IV criteria for functional dyspepsia were designed to improve the specificity of definitions. “The emphasis is now on PDS and EPS, not on larger functional disorders. Furthermore, these two subgroups are not mutually exclusive; there can be overlap,” he said. He cautioned physicians to not confuse functional dyspepsia with gastroparesis and also discussed how many cases of functional dyspepsia are now mislabeled as gastroesophageal reflux disease (GERD). Talley also briefly presented convincing data that suggest that GERD and irritable bowel syndrome (IBS) may be part of a larger spectrum of functional gastrointestinal disorders.

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