Journal of Gastroenterology

, Volume 43, Issue 4, pp 251–255 | Cite as

Functional dyspepsia: past, present, and future

  • Brecht Geeraerts
  • Jan Tack


Functional dyspepsia (FD) is a highly prevalent gastrointestinal disorder characterized by symptoms originating from the gastroduodenal region in the absence of underlying organic disease that readily explains the symptoms. The Rome II consensus, which defined FD as the presence of unexplained pain or discomfort in the epigastrium, had a number of drawbacks, including an unjustified focus on pain, inclusion of a large number of nonspecific symptoms, and an unclear position on overlap with gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS). The Rome III consensus redefined FD as the presence of epigastric pain or burning, postprandial fullness or early satiation in the absence of underlying organic disease. Frequent overlap with GERD and IBS is acknowledged but does not exclude a diagnosis of FD. A subgroup classification into postprandial distress syndrome and epigastric pain syndrome was proposed. Ongoing studies will clarify the impact of this subdivision on clinical management and treatment outcomes.

Key words

Rome III consensus postprandial distress syndrome (PDS) epigastric pain syndrome (EPS) postprandial fullness early satiation 


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  1. 1.
    Drossman DA. The Rome Foundation and Rome III. Neurogastroenterol Motil 2007;19:783–786.CrossRefPubMedGoogle Scholar
  2. 2.
    Colin-Jones DG, Bloom B, Bodemar G, Crean G, Freston J, Gugler R, et al. Management of dyspepsia: report of a working party. Lancet 1988;1:576–579.Google Scholar
  3. 3.
    Barbara L, Camilleri M, Corinaldesi R, Crean GP, Heading RC, Johnson AG, et al. Definition and investigation of dyspepsia. Consensus of an international ad hoc working party. Dig Dis Sci 1989;34:1272–1276.CrossRefPubMedGoogle Scholar
  4. 4.
    Talley NJ, Koch KL, Koch M, et al. Functional dyspepsia: a classification with guidelines for diagnosis and management. Gastrointest Int 1991;4:145–160.Google Scholar
  5. 5.
    Talley NJ, Stanghellini V, Heading RC, Koch KL, Malagelada JR, Tytgat GNJ. Functional gastroduodenal disorders. Gut 1999;45(Suppl) II:37–42.Google Scholar
  6. 6.
    Tack J, Talley NJ, Camilleri M, Holtmann G, Hu PJ, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology 2006;130:1466–1479.CrossRefPubMedGoogle Scholar
  7. 7.
    Stanghellini V. Review article: pain versus discomfort—is differentiation clinically useful? Aliment Pharmacol Ther 2001;15:145–149.CrossRefPubMedGoogle Scholar
  8. 8.
    Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology 2004;127:1239–1255.CrossRefPubMedGoogle Scholar
  9. 9.
    Laheij RJ, De Koning RW, Horrevorts AM, Rongen RJ, Rossum LG, Witteman EM, et al. Predominant symptom behavior in patients with persistent dyspepsia during treatment. J Clin Gastroenterol 2004;38:490–495.CrossRefPubMedGoogle Scholar
  10. 10.
    Talley NJ, Locke GR 3rd, Lahr BD, Zinsmeister AR, Tougas G, Ligozio G, et al. Functional dyspepsia, delayed gastric emptying, and impaired quality of life. Gut 2006;55:933–939.CrossRefPubMedGoogle Scholar
  11. 11.
    Westbrook JI, Talley NJ. Empiric clustering of dyspepsia into symptom subgroups: a population-based study. Scand J Gastroenterol 2002;37:917–923.CrossRefPubMedGoogle Scholar
  12. 12.
    Fischler B, Vandenberghe J, Persoons P, De Gucht V, Broekaert D, Luyckx K, et al. Evidence-based subtypes in functional dyspepsia with confirmatory factor analysis: psychosocial and physiopathological correlates. Gastroenterology 2003;124:903–910.CrossRefPubMedGoogle Scholar
  13. 13.
    Tack J, Talley NJ, Coulie B, Dubois D, Jones M. Association of weight loss with gastrointestinal symptoms in a tertiary-referred patient population. Gastroenterology 2003 (abstract).Google Scholar
  14. 14.
    Jones M, Talley N, Coulie B, Dubois J, Tack J. Association of weight loss with gastrointestinal symptoms. Gastroenterology 2003 (abstract).Google Scholar
  15. 15.
    Kwan AC, Bao TN, Chakkaphak S, Chang FY, Ke MY, Law NM, et al. Validation of Rome II criteria for functional gastrointestinal disorders by factor analysis of symptoms in Asian patient sample. J Gastroenterol Hepatol 2003;18:796–802.CrossRefPubMedGoogle Scholar
  16. 16.
    Whitehead WE, Bassotti G, Palsson O, Taub E, Cook EC III, Drossman DA. Factor analysis of bowel symptoms in US and Italian populations. Dig Liv Dis 2003;35:774–783.CrossRefGoogle Scholar
  17. 17.
    Camilleri M, Dubois D, Coulie B, Jones M, Stewart WF, Sonnenberg A, et al. Results from the US upper gastrointestinal study: prevalence, socio-economic impact and functional gastrointestinal disorder subgroups identified by factor and cluster analysis. Clin Gastroenterol Hepatol 2005;3:543–552.CrossRefPubMedGoogle Scholar
  18. 18.
    Piessevaux H, De Winter B, Louis E, Muls V, De Looze D, Pelckmans P, et al. Dyspeptic symptoms in the general population: a factor and cluster analysis of symptom groupings. 2008 (submitted).Google Scholar
  19. 19.
    Castillo EJ, Camilleri M, Locke GR, Burton DD, Stephens DA, Geno DM, et al. A community-based, controlled study of the epidemiology and pathophysiology of dyspepsia. Clin Gastroenterol Hepatol 2004;2:985–996.CrossRefPubMedGoogle Scholar
  20. 20.
    Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K, et al. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 1998;33:1023–1029.CrossRefPubMedGoogle Scholar
  21. 21.
    Peura DA, Kovacs TO, Metz DC, Siepman N, Pilmer BL, Talley NJ. Lansoprazole in the treatment of functional dyspepsia: two double-blind, randomized, placebo-controlled trials. Am J Med 2004;116:740–748.CrossRefPubMedGoogle Scholar
  22. 22.
    Tack J, Caenepeel P, Arts J, Lee KJ, Sifrim D, Janssens J. Prevalence and symptomatic impact of non-erosive reflux disease in functional dyspepsia. Gut 2005;10:1370–1376.CrossRefGoogle Scholar
  23. 23.
    Talley NJ, Meineche-Schmidt V, Pare P, Duckworth M, Raisanen P, Pap A, et al. Efficacy of omeprazole in functional dyspepsia: double-blind, randomized, placebo-controlled trials (the Bond and Opera studies). Aliment Pharmacol Ther 1998;12:1055–1065.CrossRefPubMedGoogle Scholar
  24. 24.
    Moayyedi P, Delaney BC, Vakil N, Forman D, Talley NJ. The efficacy of proton pump inhibitors in nonulcer dyspepsia: a systematic review and economic analysis. Gastroenterology 2004;127:1329–1337.CrossRefPubMedGoogle Scholar
  25. 25.
    Corsetti M, Caenepeel P, Fischler B, Janssens J, Tack J. Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia. Am J Gastroenterol 2004;99:1152–1159.CrossRefPubMedGoogle Scholar
  26. 26.
    Moayyedi P, Soo S, Deeks J, Delaney B, Harris A, Innes M, et al. Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database Syst Rev 2006 Apr 19;(2):CD002096.PubMedGoogle Scholar
  27. 27.
    Moayyedi P, Delaney BC, Vakil N, Forman D, Talley NJ. The efficacy of proton pump inhibitors in nonulcer dyspepsia: a systematic review and economic analysis. Gastroenterology 2004;127:1329–1337.CrossRefPubMedGoogle Scholar
  28. 28.
    Moayyedi P, Soo S, Deeks J, Delaney B, Innes M, Forman D. Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev 2006 Oct 18;(4):CD001960.PubMedGoogle Scholar
  29. 29.
    Hiyama T, Yoshihara M, Matsuo K, Kusunoki H, Kamada T, Ito M, et al. Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia. J Gastroenterol Hepatol 2007;22:304–310.CrossRefPubMedGoogle Scholar
  30. 30.
    Hojo M, Miwa H, Yokoyama T, Ohkusa T, Nagahara A, Kawabe M, et al. Treatment of functional dyspepsia with antianxiety or antidepressive agents: systematic review. J Gastroenterol 2005;40:1036–1042.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2008

Authors and Affiliations

  • Brecht Geeraerts
    • 1
  • Jan Tack
    • 1
  1. 1.Center for Gastroenterological Research K.U. LeuvenLeuvenBelgium

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