Effects of Rome IV Definitions of Functional Dyspepsia Subgroups in Secondary Care

Houte, Karen Van den; Carbone, Florencia; Goelen, Nick; Schol, Jolien; Masuy, Imke; Arts, Joris; Caenepeel, Philip; Staessen, Dirk; Vergauwe, Philippe; Roey, G Van; Latour, Pascale; Piessevaux, Hubert; Maldague, P; Gerkens, Ariane; Wuestenberghs, Fabien; Vandenberghe, Alain; Tack, Jan

doi:10.1016/j.cgh.2020.06.043

Cited by 26 publications

(28 citation statements)

References 26 publications

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“…The existence of these subtypes in the general population is supported by epidemiological data 3 . With the Rome III definitions, a major overlap between EPS and PDS was found, but this is substantially decreased with the Rome IV update 1,3,10,11,40 …”

Section: Resultsmentioning

confidence: 87%

“…The literature is divided on the usefulness of distinguishing PDS and EPS for patient management. When the Rome III subdivision is used, a major overlap is found between both, which is largely corrected with the Rome IV subdivision as a good separation between both subtypes is now found both in epidemiological studies and in clinical practice 3,11,40,156–158 . While some studies report different treatment responses, 159,160 others do not 161,162 .…”

Section: Resultsmentioning

confidence: 99%

“…3 With the Rome III definitions, a major overlap between EPS and PDS was found, but this is substantially decreased with the Rome IV update. 1,3,10,11,40 Assessing the presence of cardinal and accessory symptoms requires an accurate understanding of symptom descriptors by the patient. It may be difficult for patients to distinguish upper gastrointestinal symptoms based on verbal descriptors alone, but adding pictograms to verbal descriptors significantly improves the accuracy of symptom reporting by FD patients.…”

Section: Definitions and Symptom Descriptorsmentioning

confidence: 99%

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United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia

Wauters

Dickman

Drug³

et al. 2021

UEG Journal

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Definitions and Symptom Descriptorsmentioning

confidence: 99%

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United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia

Wauters

Dickman

Drug³

et al. 2021

UEG Journal

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“…In practices of TKM/TCM, clinicians have adapted the pattern identification in processes of diagnosis and treatment for certain disorders including FD, which stresses the cluster of symptoms with its affecting factors (Ko et al, 2014). FD has generally divided into two subgroups as postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) (Houte et al, 2020), in conventional medicine, while TKM/TCM generally classify FD into six different identifications (Kim et al, 2010). Of those, the "liver Qi invading stomach (肝气犯胃)" pattern is most common in Korean FD patients (approximately 52.9%) (Park et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial

et al. 2021

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Background: Functional dyspepsia (FD) is a highly complex pathophysiologic disease, which shows low recovery and high relapse rates. Therefore, a growing number of clinicians and patients are looking for alternative herbal medicine. Banha-Sasim-Tang (BST) is an herbal prescription for treating a wide range of dyspepsia in traditional Korean medicine (TKM).Aim of the study: This study aimed to evaluate the efficacy of BST on FD in patients with psychological stress-related symptoms and to investigate the involvement of ghrelin. This study is registered at https://cris.nih.go.kr/with the identification number KCT 0002811.Materials and methods: A total of 31 participants with FD who met the Rome IV criteria and the psychological stress-related pattern were enrolled in a double-blind, randomized, and controlled study. Participants were randomly assigned to the BST group (10 g twice daily for 4 weeks) or placebo group. The primary endpoint was a change in the Nepean Dyspepsia Index–Korean (NDI-K) score. The secondary endpoints were changes in the Visual Analog Scale (VAS) scores and plasma ghrelin level.Results: All participants completed the study (n = 15 for BST, n = 16 for placebo). BST decreased NDI-K scores compared with placebo, but the difference was not statistically significant (37.40 ± 27.40 vs 22.50 ± 23.85, p = 0.12). VAS scores and plasma total ghrelin levels were significantly improved in patients who were treated with BST (3.19 ± 1.60 vs 1.38 ± 2.85, p = 0.03 for VAS and 105.69 ± 287.89 vs -142.31 ± 314.32, p = 0.03 for total ghrelin). No BST-related adverse effects were observed during the trial.Conclusion: Our results indicate the clinical potential of BST for FD patients and are the first study to show the modulation of plasma ghrelin as one of its corresponding mechanisms.Clinical Trial Registration:https://cris.nih.go.kr/, identifier KCT 0002811.

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“…The Rome definitions have been developed to better differentiate between patients with gastro-esophageal reflux disease or with functional dyspepsia for inclusion in studies. There is however considerable overlap in symptom presentation in these patients, making the Rome definitions less suitable for everyday clinical practice [11,12]. Another, more suitable definition for clinical practice, is that of the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) defining dyspepsia as the presence of predominant epigastric pain lasting one month, which can be associated with upper GI symptoms such as epigastric fullness, nausea, vomiting or heartburn [1].…”

Section: Introductionmentioning

confidence: 99%

The yield of upper gastrointestinal endoscopy in patients below 60 years and without alarm symptoms presenting with dyspepsia

Theunissen

Lantinga

Borg

et al. 2021

Scandinavian Journal of Gastroenterology

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Background and aims: Upper gastrointestinal (GI) endoscopy is frequently performed in patients with upper abdominal symptoms. Although guidelines recommend withholding an endoscopy in the absence of alarm symptoms, dyspeptic symptoms remain a predominant indication for endoscopy. We aimed to investigate the yield of upper GI endoscopy in patients with low-risk dyspeptic symptoms. Methods: We conducted an analysis in a prospectively maintained endoscopy reporting database. We collected the results of all upper GI endoscopy procedures between 2015 and 2019 that was performed in adult patients aged <60 years with dyspeptic symptoms. Patients with documented alarm symptoms were excluded. We categorized endoscopic findings into major and minor endoscopic findings. Results: We identified 26,440 patients with dyspeptic symptoms who underwent upper GI endoscopy. A total of 13,978 patients were considered low-risk and included for analysis (median age 46 years, interquartile range (IQR) [36-53], 62% female). In 11,353 patients (81.2%), no endoscopic abnormalities were detected. Major endoscopic findings were seen in 513 patients (3.7%) and minor endoscopic findings in 2178 patients (15.6%). Endoscopic findings indicative of upper GI cancer were reported in 47 patients (0.3%), including 16 (0.1%) oesophageal, 28 (0.2%) gastric and 5 (0.04%) duodenal lesions. Despite an initial unremarkable endoscopy result, 1015 of 11,353 patients (8.9%) underwent a followup endoscopy after a median of 428 days . This did not lead to the additional identification of malignancy. Conclusions: The yield of upper GI endoscopy in low-risk (<60 years, no alarm symptoms) patients with dyspepsia is very limited. This study further supports a restrictive use of upper GI endoscopy in these patients.

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Effects of Rome IV Definitions of Functional Dyspepsia Subgroups in Secondary Care

Cited by 26 publications

References 26 publications

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia

Beneficial Potential of Banha-Sasim-Tang for Stress-Sensitive Functional Dyspepsia via Modulation of Ghrelin: A Randomized Controlled Trial

The yield of upper gastrointestinal endoscopy in patients below 60 years and without alarm symptoms presenting with dyspepsia

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