Functional gastroduodenal disorders

Abstract

While widely used in research, the 1991 Rome criteria for the gastroduodenal disorders, especially symptom subgroups in dyspepsia, remain contentious. After a comprehensive literature search, a consensus-based approach was applied, supplemented by input from international experts who reviewed the report. Three functional gastroduodenal disorders are defined. Functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen; evidence of organic disease likely to explain the symptoms is absent, including at upper endoscopy. Discomfort refers to a subjective, negative feeling that may be characterized by or associated with a number of non-painful symptoms including upper abdominal fullness, early satiety, bloating, or nausea. A dyspepsia subgroup classification is proposed for research purposes, based on the predominant (most bothersome) symptom: (a) ulcer-like dyspepsia when pain (from mild to severe) is the predominant symptom, and (b) dysmotility-like dyspepsia when discomfort (not pain) is the predominant symptom. This classification is supported by recent evidence suggesting that predominant symptoms, but not symptom clusters, identify subgroups with distinct underlying pathophysiological disturbances and responses to treatment. Aerophagia is an unusual complaint characterized by air swallowing that is objectively observed and troublesome repetitive belching. Functional vomiting refers to frequent episodes of recurrent vomiting that is not self-induced nor medication induced, and occurs in the absence of eating disorders, major psychiatric diseases, abnormalities in the gut or central nervous system, or metabolic diseases that can explain the symptom. The current classification requires careful validation but the criteria should be of value in future research. (Gut 1999;45(Suppl II):II37-II42)

Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six‐week placebo‐controlled, double‐blind, multicentre trial

“…2 The distribution of symptom types was similar in the two treatment groups (P > 0.91), with dysmotility-like functional dyspepsia being the most frequent in both groups (Table 1).…”

“…Dyspepsia in the absence of a clinically identifiable structural lesion causing symptoms is referred to as functional dyspepsia. 1,2 Because a structural explanation is lacking, disturbed gastrointestinal function (GI) is believed to play a role in the development of symptoms. 3 Pharmacological treatment for patients with functional dyspepsia remains unsatisfactory.…”

II Consenso Brasileiro sobre Helicobacter pylori

“…O Consenso aprovou o conceito de dispepsia funcional emanado pelo Consenso Roma II (22) , ou seja, presença de dispepsia persistente ou recurrente (dor ou desconforto localizado na região central do abdome superior), com duração mínima de 12 semanas, não necessariamente consecutivas nos últimos 12 meses, sem evidências à endoscopia digestiva alta, de doença orgânica que justifique os sintomas e sem evidências de que a dispepsia seja aliviada exclusivamente pela defecação ou associada com o aparecimento de alterações na freqüência ou forma das fezes, acrescido da exclusão de parasitoses intestinais ao exame coprológico.…”

A rapid, low‐dose, 13C‐urea tablet for the detection of Helicobacter pylori infection before and after treatment

“…Dyspepsia was defined as pain or discomfort in the upper abdomen. 4 All patients had suffered from symptoms for at least 2 months. The patients had not been investigated or treated previously for H. pylori infection.…”