Chapter 4 DYSPEPSIA AND FUNCTIONAL DYSPEPSIA
DEFINITIONS
The Rome III committee has redefined functional dyspepsia and limited the term to refer to the four following symptoms: bothersome post-prandial fullness, early satiation, epigastric pain, or epigastric burning. The remaining symptoms of discomfort listed above have been allocated clinical entities of their own, and together they comprise the functional gastroduodenal disorders (Table 4.1). In addition, as shown in Table 4.2, there are two new diagnostic categories within functional dyspepsia; namely postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).
Diagnostic criteria*for postprandial distress syndrome |
Must include one or both of the following: |
1. Bothersome postprandial fullness, occurring after ordinary sized meals, at least several times per week |
Supportive criteria |
Diagnostic criteria*for epigastric pain syndrome |
Must include all of the following: |
1. Pain or burning localised to the epigastrium of at least moderate severity at least once per week |
Supportive criteria |
* Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis
CAUSES
Organic
Organic causes of dyspepsia are many and varied as outlined in Table 4.3, but the majority of cases are due to peptic ulcer disease, gastro-oesophageal reflux and malignancy.
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