New classification Rome IV functional dyspepsia and subtypes

Futagami, Seiji; Yanagawa, Hiroshi; Agawa, Shuhei; Higuchi, Kazutoshi; Ikeda, Go; Noda, Hiroto; Kirita, Kumiko; Akimoto, Teppei; Wakabayashi, Mako; Sakasegawa, Noriko; Kodaka, Yasuhiro; Ueki, Nobue; Kawagoe, Tetsuro; Iwakiri, Katsuhiko

doi:10.21037/tgh.2018.09.12

Cited by 27 publications

(24 citation statements)

References 21 publications

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“…4 There have been changes to the internationally accepted definition of dyspepsia over the last 20 years, including to the Rome diagnostic criteria, 5 which has implications for the estimated global prevalence of uninvestigated dyspepsia of 20.8%, and 5% – 11% for functional dyspepsia. 6 While a revision of the diagnostic criteria in the 2016 Rome IV diagnostic criteria will have implications for future FD prevalence rates, 7 figures as high as 60% have been reported from Jordan, 8 21% from the United Kingdom 9 and 26% from the United States. 10 According to Ghoshal et al, 11 8% – 23% of Asian people suffer from FD and a rate of 45% has been reported in one sample of a Nigerian community.…”

Section: Introductionmentioning

confidence: 99%

Depression, anxiety and stress symptoms in patients presenting with dyspepsia at a regional hospital in KwaZulu-Natal province

2019

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BackgroundDepression, anxiety and stress (DAS) have been shown to be co-morbid with dyspepsia. Local data on the factors associated with these co-morbidities could inform the role of psychiatric intervention in affected patients.AimThe aim of this study was to describe the frequency of undiagnosed DAS and their associated protective and risk correlates in a sample of patients undergoing endoscopies for dyspepsia.SettingThe study was conducted at a regional hospital’s gastro-intestinal unit in KwaZulu-Natal province.MethodA cross-sectional survey was conducted on 201 in- and outpatients with symptoms of dyspepsia awaiting endoscopy. Information on DAS symptomatology (using the DASS-21 screening questionnaire, as well as socio-demographic and clinical data) were collected.AnalysesFollowing a descriptive analysis of the participants’ socio-demographic and clinical details, linear regression models were fitted to identify potential risk and protective correlates linked to DAS symptomatology.ResultsThe mean age of participants (N = 201) was 48.89 years, of whom approximately two-thirds (n = 133; 66.17%) were women, 97% (n = 195) were African and 64.68% (n = 130) resided in rural areas. Anxiety was the most prevalent symptom category (n = 149; 74.13%) versus depression (n = 96; 47.76%) and stress (n = 68; 33.83%) in each category of symptom (mild to extremely) severity. In the severe and extremely severe range, anxiety existed without co-morbid depression or stress in 61.19% of anxious patients. Alcohol use was significantly associated with all three symptom categories (p < 0.01).ConclusionsGiven high frequencies of depression and anxiety in patients undergoing endoscopies for dyspepsia, screening for common mental disorders is essential.

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Section: Introductionmentioning

confidence: 99%

Depression, anxiety and stress symptoms in patients presenting with dyspepsia at a regional hospital in KwaZulu-Natal province

2019

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“…According to the Rome III classification, FD comprises two subtypes: epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). The recent Rome IV classification adds a subtype which has overlapping EPS and PDS features (5). It is known that treatments for EPS and PDS require different approaches.…”

Section: Introductionmentioning

confidence: 99%

“…It is known that treatments for EPS and PDS require different approaches. PDS is mainly treated with prokinetic drugs, while EPS is commonly treated with acid secretion inhibitors (5). Different FD subtypes may have different pathophysiology (1,6,7); however, the underlying mechanisms which contribute to those differences remain poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Similarity and diversity of spontaneous brain activity in functional dyspepsia subtypes

Zhao

Weng

et al. 2019

Acta Radiol

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Background Functional dyspepsia (FD) subtypes may differ in terms of pathophysiology, but the underlying mechanisms remain poorly understood. Purpose To explore spontaneous brain activity in two main FD subtypes, namely epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), using the amplitude of low-frequency fluctuation (ALFF). Material and Methods Thirty-one FD patients (18 EPS and 13 PDS) and 22 matched healthy controls (HC) underwent resting-state functional MRI scanning. Spontaneous brain activity was evaluated by measuring the ALFF and then compared among the EPS, PDS, and HC groups with ANOVA test. Pearson correlation analysis was performed between the ALFF values and clinical indices. Results Compared to healthy controls, both EPS and PDS patients had increased ALFF in the bilateral precentral/postcentral gyri, insula, and thalami. Furthermore, only the EPS patients displayed increased ALFF in the right middle and inferior frontal gyri, and only the PDS patients showed increased ALFF in the left posterior cingulate cortex (PCC). The ALFF values in the left thalamus were positively correlated with the sleep disturbance in EPS patients, and the ALFF values in the right precentral/postcentral gyri showed a positive correlation with the symptom score in PDS patients. Conclusion EPS and PDS had similarities of higher spontaneous brain activity in the primary motor/sensory areas and homeostatic-afferent network regions, and differences in the prefrontal region and PCC, providing evidence to suggest the similarity and diversity of pathophysiology in FD subtypes.

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“…The Rome IV committee (an organisation striving to improve understanding of functional gastrointestinal disorders) updated their criteria on functional dyspepsia in 2016. 3 The new criteria define dyspepsia as one or more of the following four symptoms for three months within the initial six months of symptom onset: • Bothersome postprandial fullness • Bothersome early satiation • Bothersome epigastric pain • Bothersome epigastric burning.…”

Section: What Is Dyspepsia?mentioning

confidence: 99%