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[Functional dyspepsia: philosopher's stone or much noise about nothing?]
1Psychophysiologisches Laboratorium an der Universitätsklinik für Chirurgie, Wien, Osterreich. georg.stacher@akh-wien.ac.at
Zeitschrift Fur Gastroenterologie
|August 16, 2001
Summary
The diagnosis of functional dyspepsia, a condition of exclusion, is questioned due to its vague terminology and lack of clear patient characteristics or specific therapies. "Idiopathic dyspepsia" is proposed as a more accurate term for unrevealed symptom causes.
Area of Science:
- Gastroenterology
- Internal Medicine
- Medical Diagnostics
Context:
- The Rome Committee defined functional dyspepsia in 1998 for patients with upper abdominal pain without identifiable disease.
- Diagnosis involves excluding organic causes through history, examination, and endoscopy off medication.
- Functional dyspepsia is currently a diagnosis of exclusion.
Purpose:
- To critically evaluate the clinical utility and conceptual basis of the functional dyspepsia diagnosis.
- To explore the implications of using a diagnosis that implies unknown or vague underlying mechanisms.
- To propose an alternative terminology for patients with unexplained dyspeptic symptoms.
Summary:
- The term 'functional dyspepsia' is problematic, suggesting organ dysfunction and creating a false dichotomy between known and unknown causes.
- Current evidence does not support shared pathophysiological or psychosocial characteristics among patients diagnosed with functional dyspepsia.
- Tailored, symptom-based treatment is necessary, making the broad 'functional dyspepsia' label of questionable value.
Impact:
- Re-evaluating diagnostic labels in gastroenterology is crucial for accurate patient management.
- The proposed term 'idiopathic dyspepsia' offers clearer communication regarding the unrevealed etiology of symptoms.
- This analysis encourages a shift towards more precise terminology in diagnosing upper gastrointestinal disorders.