Abstract
Background
The Rome IV criteria for functional dyspepsia (FD) has strict requirements for symptom frequency and onset duration, making it challenging to identify patients with broadly defined FD in clinical practice.
Aims
This study aimed to investigate the impact of relaxing the Rome IV criteria on the diagnosis and symptom pattern of FD.
Methods
A cross-sectional, multi-center study was conducted involving 2935 consecutive broadly defined FD patients with no positive findings on upper GI endoscopy and routine examinations. Questionnaires were used to collect demographic and upper gastrointestinal symptom data. Symptom pattern was compared between Rome IV criteria defined FD patients and those defined by relaxed Rome IV criteria.
Results
Only 22.2% of broadly defined FD patients rigorously fulfilled Rome IV criteria. No significant difference was found for all symptoms mentioned in this study, as well as dyspeptic symptom severity and onset frequency, between broadly defined FD who fulfilled Rome IV criteria but had a duration of 3–6 months and Rome IV criteria defined FD. Broadly defined Postprandial Distress Syndrome (PDS) patients who fulfilled the Rome IV criteria but had a symptom frequency of 1–2 days per week had significantly lower symptom severity, but similar postprandial symptom characteristics compared to those defined by the Rome IV criteria.
Conclusion
A symptom duration criterion of 3 months may be sufficient for diagnosing FD in China. Reducing the symptom onset frequency to no less than 1 day per week in the Rome IV criteria for PDS does not affect its postprandial symptom characteristics.