5-Minute Clinical Consult Explore these free sample topics:
-- The first section of this topic is shown below --
- The presence of bothersome postprandial fullness, early satiety, or epigastric pain/burning in the absence of causative structural disease (to include normal upper endoscopy) for the preceding 3 months with initial symptom onset at least 6 months prior to diagnosis (Rome III criteria)
- Rome III criteria divide patients into two subtypes:
- Postprandial distress syndrome
- Epigastric pain syndrome
- System(s) affected: GI
- Synonym(s): idiopathic dyspepsia; nonulcer dyspepsia; nonorganic dyspepsia; postprandial distress syndrome; and epigastric pain syndrome
Unknown, accounts for 70% of patients with dyspepsia, and ∼5% of primary care visits
- 15–30% prevalence in developed countries (3–10% when strict Rome III criteria are used)
- Predominant age: adults but can be seen in children
- Predominant gender: female > male
Etiology and Pathophysiology
Unknown, but proposed mechanisms or associations include gastric motility disorders, visceral pain hypersensitivity, Helicobacter pylori infection, alteration in upper GI microbiome, medications, anxiety, and depression
Possible link to G-protein β-3 subunit 825 CC genotype and serotonin transport genes
Be alert for family system dysfunction.
Pregnancy may exacerbate symptoms.
Patients >50 years with new-onset dyspepsia should have an upper endoscopy.
- Other functional disorders
- Anxiety/depression psychosocial factors: divorce, unemployment
Avoid foods and habits known to exacerbate symptoms.
Commonly Associated Conditions
Other functional bowel disorders