Functional Dyspepsia, 2016

Nicholas J. Talley; Marjorie M. Walker; Gerald Holtmann


Curr Opin Gastroenterol. 2016;32(6):467-473. 

In This Article

Rome IV

In 2016, the new Rome IV criteria for diagnosis of functional dyspepsia were presented at Digestive Disease Week (DDW) and published in Gastroenterology.[4] Rome IV emphasizes that functional dyspepsia should not be considered a single disorder. The subclassification of functional dyspepsia into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) was retained. Epidemiological and pathophysiological evidence over the past several years has strengthened the notion that these syndromes are separate entities in the main but can overlap. Notably, PDS and EPS overlap more frequently in outpatient cohorts in contrast to population-based studies.[1] Table 1 summarizes the Rome IV PDS and EPS criteria and compares them with Rome III; especially only minor changes were made in defining the syndrome's symptoms. However, a major change was the acceptance of the evidence that gastroesophageal reflux disease (GERD) symptoms and the symptoms of the irritable bowel syndrome (IBS) overlap more than expected by chance with functional dyspepsia, and conclude that these disorders are part of the spectrum of functional dyspepsia; exclusion of GERD or IBS from future trials is not necessarily required.