Usefulness and Discriminant Value of ROME III Questionnaire in Dyspeptic Patients without Anti- Secretory Therapy

Abstract

Purpose: To evaluate the usefulness of Rome III questionnaire for the diagnosis functional dyspepsia (FD) and to discriminate between Postprandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS) in patients with dyspepstic symptoms. Methods: Consecutive patients, who were not on proton pump inhibitors, were asked to participate. Rome III questionnaire was used to identify the patients as having FD and PDS or EPS as groups. Gastro-duodenal biopsies, liver function tests and ultrasound were also done. Results: Out of 272 patients 191 (70%) fulfilled the Rome III criteria of Functional Dyspepsia (FD). PDS variant was found in 17 (9%) patients, EPS in 109 (57%) and overlap between EPS and PDS was present in 56 (29%) and 9 (5%) patients did not fit the Rome III criteria of either category. Diagnosis of FD was established in 136 (71%) patients only. Gastritis was present in 116 patients (85%), Duodenitis in 44 (32%) and Heliobacter pylori infection in 70 (51%) patients. Among 55 patients (29%) who were found to have organic diseases, EPS was seen in 35 (64%), PDS in 5 (9%) and overlap in 15 (27%) patients. Underlying organic causes were gastric or duodenal ulcers 14, Barrets esophagus; 5, chronic liver disease; 7, gall stones; 5, giardiasis and celiac disease in 3 each. Gastric carcinoma, Crohns disease and gastric polyps were seen in one patient each. Conclusion: The study indicates that 1/3 of patients who fulfilled the Rome III criteria for functional dyspepsia actually had organic disease. Almost 1/3rd of the patients did not qualify in one of the sub-group of functional dyspepsia. Epigastric pain syndrome and overlap with post prandial distension were the dominant groups in dyspeptic patients. There is a need to define an overlap group in Rome III criteria for functional dyspepsia.