Rome IV Diagnostic Criteria for Functional Dyspepsia
Official Rome IV criteria for the diagnosis of functional dyspepsia.
Use in patients with symptoms suggestive of functional dyspepsia such as chronic and recurrent epigastric pain, discomfort, fullness, burning and early satiety for at least 6 months.
Patients with any of the following features must be evaluated clinically for other diagnoses even though functional dyspepsia may be present:
- Signs or symptoms of GI bleeding.
- Unexplained iron deficiency anemia.
- Unintentional weight loss.
- Palpable abdominal mass or lymphadenopathy on exam.
- Family history of gastric cancer and no recent upper endoscopy.
- Dysphagia.
- Persistent vomiting.
If diagnosis not met (negative):
Symptoms are unlikely to be caused by functional dyspepsia. Consider further assessment for other pathology or a different functional gastrointestinal disease diagnosis.
If meets diagnosis (positive):
Likely diagnosis of functional dyspepsia. Consider management per current American College of Gastroenterology (ACG) guidelines.
Management of functional dyspepsia should be based on the subcategorization.
For postprandial distress syndrome (PDS):
- Mirtazepine.
- Buspirone.
- Prokinetic medications.
- Behavioral therapy.
For epigastric pain syndrome (EPS):
- Treatment of H. pylori.
- Proton pump inhibitor.
- Tricyclic antidepressant or other neuromodulators.
- Behavioral therapy.
Consult ACG guidelines for further details.
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This calculator should only be used in patients after appropriate organic, systemic, and metabolic causes have been ruled out after careful investigation, which includes upper endoscopy.
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Note: other GI conditions, such as GERD and IBS may coexist with functional dyspepsia.