Background & Aims

Functional dyspepsia (FD) is subdivided into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) according to the Rome III consensus. In clinical practice, there is a major overlap between these subgroups. The Rome IV criteria included postprandially occurring symptoms in the PDS subgroup. We aimed to analyze the effects of the Rome IV criteria, compared with Rome III, on FD subgroups in patients recruited from secondary care.

Methods

Patients with FD (n = 224; mean age, 43 ± 1 y; 77% women) were recruited from secondary-care units in Belgium and filled out symptom questionnaires, allowing subdivision according to Rome III and Rome IV criteria and identification of postprandial symptoms. Symptom patterns and demographics were compared between the subgroups. Statistical analysis was performed using the t test and the Fisher exact test.

Results

According to the Rome III criteria, 25% of participants had PDS, 8% had EPS, and 67% had an overlap. Postprandial fullness, early satiation, and bloating were present in significantly more patients in the PDS and overlap groups than the EPS group (P < .0001). A higher proportion of patients in the overlap group showed symptoms such as postprandial epigastric pain and nausea than in the EPS group (both P ≤ .02). With the Rome IV criteria, the overlap group was reduced to 35%; 57% of patients were considered to have PDS and 8% to have EPS. Postprandial pain was significantly more prevalent in the PDS than in the EPS group (P ≤ .002), and postprandial nausea was significantly more prevalent in the PDS group than the overlap group (P = .007).

Conclusions

Compared with Rome III criteria, the Rome IV criteria significantly reduces the overlap between PDS and EPS groups. Studies are needed to determine if Rome IV subgroups are associated differently with psychological comorbidities and treatment responses.

中文翻译：

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罗马 IV 定义对二级保健功能性消化不良亚组的影响

背景与目标

根据罗马 III 共识，功能性消化不良（FD）分为餐后窘迫综合征（PDS）和上腹痛综合征（EPS）。在临床实践中，这些亚组之间存在重大重叠。罗马 IV 标准包括 PDS 亚组中出现的餐后症状。我们旨在分析罗马 IV 标准与罗马 III 标准相比，对从二级医疗机构招募的患者的 FD 亚组的影响。

方法

FD 患者（n = 224；平均年龄，43 ± 1 岁；77% 为女性）从比利时的二级保健单位招募并填写症状问卷，允许根据罗马 III 和罗马 IV 标准进行细分并确定餐后症状. 比较了亚组之间的症状模式和人口统计学。使用t检验和Fisher精确检验进行统计分析。

结果

根据罗马 III 标准，25% 的参与者有 PDS，8% 有 EPS，67% 有重叠。餐后饱腹感、早饱和腹胀在 PDS 和重叠组中的患者明显多于 EPS 组 ( P < .0001)。重叠组中出现餐后上腹痛和恶心等症状的患者比例高于 EPS 组（均P ≤ .02）。使用罗马IV标准，重叠组减少到35%；57% 的患者被认为患有 PDS，8% 的患者被认为患有 EPS。PDS 组餐后疼痛的发生率显着高于 EPS 组（P ≤ .002），PDS 组餐后恶心的发生率显着高于重叠组（P = .007）。

结论

与罗马 III 标准相比，罗马 IV 标准显着减少了 PDS 和 EPS 组之间的重叠。需要研究来确定罗马 IV 亚组是否与心理合并症和治疗反应有不同的关联。