Diagnostic Criteria for Functional Dyspepsia

Definition and Diagnostic Criteria

The Rome IV criteria require the presence of one or more bothersome symptoms, including epigastric pain, epigastric burning, postprandial fullness, or early satiation, with symptom onset at least 6 months prior to diagnosis and symptoms active within the past 3 months, and no evidence of structural disease likely to explain the symptoms 1, 2, 3
Functional dyspepsia requires one or more of the following bothersome symptoms: bothersome epigastric pain, bothersome epigastric burning, bothersome postprandial fullness, or bothersome early satiation 1, 2, 4

Symptom onset at least 6 months prior to diagnosis and symptoms should be active within the past 3 months 1, 2, 4
No evidence of structural disease likely to explain the symptoms 1, 2

Epigastric Pain Syndrome (EPS) must include one or both of the following symptoms at least 1 day a week: bothersome epigastric pain or bothersome epigastric burning, severe enough to impact usual activities 1, 2, 3
Postprandial Distress Syndrome (PDS) must include one or both of the following symptoms at least 3 days a week: bothersome postprandial fullness or bothersome early satiation, severe enough to impact usual activities 1, 2, 4

Approximately 80% of people with dyspepsia in community surveys have functional dyspepsia, with the remainder having organic causes such as erosive esophagitis, peptic ulcer, or gastroesophageal cancer 5, 6
Risk factors for functional dyspepsia include younger age, female sex, higher levels of somatoform-type symptom reporting, and other digestive disorders including IBS 5, 6
Functional dyspepsia and gastroparesis have significant overlapping features and cannot be fully distinguished based on symptoms or gastric emptying studies alone; the term "FD with or without delayed gastric emptying" may be preferable 1, 4