**3. Definitions of functional dyspepsia symptoms [1]**

The Rome III committee proposed a distinction between meal-induced symptoms and mealunrelated symptoms to be pathophysiologically, clinically and therapeutically relevant.

Epigastric pain syndrome:

**1.** Epigastric pain

I and Rome II criteria did not account for meal-related symptoms and this was the fundamental

Rome III criteria made a distinction between meal-induced symptoms and meal-unrelated

**1.** Meal-induced dyspeptic symptoms (postprandial distress syndrome, which is character‐

**2.** Epigastric pain syndrome or EPS, characterized by epigastric pain and epigastric burning.

The traditional definition of FD portrays it as an idiopathic condition [10]. However, recent studies suggest that this condition have some pathophysiologic correlates. A diversity of changes in gastrointestinal structure and function has been described in this heterogeneous disorder. In this chapter, the author attempts to provide an overview of structural and physiological alterations in FD beyond those demonstrable by conventional tests used to

According to Rome III criteria, FD must include one or more of the following symptoms: bothersome postprandial fullness, early satiation, epigastric pain and epigastric burning; with no evidence of structural disease, including use of upper gastrointestinal endoscopy, which is likely to explain the symptoms. Criteria should be fulfilled for at least 3 months with symptom

Older terms that represent FD are non-ulcer dyspepsia, idiopathic or essential dyspepsia. The term non ulcer dyspepsia is still popular but no longer recommended because it implies that the patient has symptoms similar to peptic ulcer disease without having an actual ulcer on endoscopic examination. The spectrum of symptoms in FD includes epigastric pain syndrome

At least 3 months, with onset at least 6 months previously, of one or more of the following:

No evidence of structural disease (including upper endoscopy) that is likely to explain the symptoms.

symptoms, and this forms the basis of newly defined subcategories of FD:

ized by postprandial fullness and early satiation)

separate organic dyspepsia from its functional counterpart.

**2. Current definition of Functional Dyspepsia**

onset at least 6 months previously [1].

and postprandial distress syndrome

**Table 1.** Rome III diagnostic criteria for functional dyspepsia [1]

• bothersome postprandial fullness

• early satiation • epigastric pain • epigastric burning

AND

change in Rome III criteria [8, 9].

14 Dyspepsia - Advances in Understanding and Management

Epigastric refers to the region between the umbilicus and lower end of the sternum, and marked by the midclavicular lines. Pain refers to a subjective, unpleasant sensation; some patients may feel that tissue damage is occurring.

**2.** Epigastric burning

Epigastric refers to the region between the umbilicus and lower end of the sternum, and marked by the midclavicular lines. Burning refers to an unpleasant subjective sensation of heat.

Postprandial distress syndrome:


Recent research findings indicate that postprandial distress syndrome and epigastric pain syndrome overlap in majority of patients with FD [11]. The implication of this is that the value of dividing FD into the subgroups of postprandial distress syndrome and epigastric pain syndrome is thus questionable [11]
