Predominant symptoms identify different subgroups in functional dyspepsia

OBJECTIVE: Dyspepsia is a common syndrome that often defies diagnosis. Whet her the unexplained (or "functional") dyspepsia represents a homogeneous sy ndrome or includes different subgroups with specific clinical features has not been clarified. The aim of this study was to investigate the relationsh ip between symptom severity, demographic features, and gastric dysmotility in a large series of patients with functional dyspepsia. METHODS: Severity of individual digestive symptoms, demographic features, a nd scintigraphic gastric emptying of solids were evaluated in 483 patients with chronic unexplained dyspepsia. RESULTS: Two main subgroups were identified. The first was characterized by predominant epigastric pain, male gender (61%), and normal gastric emptyin g. The second subgroup was characterized by predominant nonpainful symptoms , female gender (60%), a high frequency of associated irritable bowel syndr ome (30%), and delayed gastric emptying (42%). A third group included appro ximately one-third of patients who did not present with any predominant sym ptom, and was characterized by a high frequency of delayed gastric emptying (30%), overlapping irritable bowel syndrome (28%), and gastroesophageal re flux disease (41%). CONCLUSIONS: Different subgroups exist among patients with functional dyspe psia seen in a referral center. They can be identified by the predominant s ymptom and are characterized by different demographic, clinical, and pathop hysiological features. (Am J Gastroenterol 1999;94:2080-2085. (C) 1999 by A m. Coll. of Gastroenterology).