Flatulent dyspepsia: a tiered symptom complex?

The symptom complex of flatulent dyspepsia is ill-defined but is made up of at least nine individual symptoms. The relationship between these symptoms is not known and thier change after cholecystectomy in gall-stone patients is unpredictable; they disappear completely in less than half the patients. We studied the symptoms in one hundred and thirty nine patients, using various computer programmes to see if the changes after operation could be predicted and if some of the symptoms were linked or formed "clusters". The results did not show any standard relationship between the symptoms. We have therefore, proposed the hypothesis of a tiered symptom complex to explain these observations. They could be produced by a motility disorder affecting different parts of the gastro-intestinal tract to a varying degree.