CiteWeb id: 19990000280

CiteWeb score: 2928

DOI: 10.1002/9781444327311.ch55

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. Dis- comfort 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 pro- posed for research purposes, based on the predominant (most bothersome) symp- tom: (a) ulcer-like dyspepsia when pain (from mild to severe) is the predominant symptom,and (b) dysmotility-like dyspep- sia 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 dis- turbances and responses to treatment. Aerophagia is an unusual complaint char- acterized by air swallowing that is objec- tively 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 eat- ing disorders, major psychiatric diseases, abnormalities in the gut or central nervous system, or metabolic diseases that can explain the symptom. The current classifi- cation requires careful validation but the criteria should be of value in future research. (Gut 1999;45(Suppl II):II37-II42)

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