[Chronic dyspepsia. Basic classification based on symptoms and relation to gastrointestinal intolerances and...

For expedient examination and treatment of chronic dyspepsias initial classification into groups which do not overlap in the main signs is necessary. Such a classification is lacking. The authors used a classification according to bitter or solely acid regurgitations and vomiting and their absence and according to the frequency and occurrence of bowel movements in the course of the day.

In a group of 366 subjects (92 men and 274 women) aged 19 to 76 years (mean 52.3 years) readily available data were evaluated statistically (chi square and agreement of two relative frequencies): symptomatology, objective finding, gastrointestinal intolerance (IT). 116 statistically significant relationships were revealed and were divided into four groups: 1, group with bitter manifestations in the morning on fasting and during the night with a relation to milk IT (less with lactose IT) and postprandial diarrhoea. 2. group with bitter manifestations after a meal and in daytime, related to biliary disease and IT of fat. 3. group with solely acid manifestations associated with IT of vinegar, alcohol, gastroaggressive drugs and oligosaccharides and peptic ulceration also in remission. 4. group without regurgitations and vomiting which needed further classification: relatively tolerant of fat but not milk. This group has a characteristic sub-group of subjects with a quiescent stage after cholecystectomy. This sub-group is a "negative" of the properties of group 3.

In the patients four defined groups of dyspepsias were defined associated with manifestations of actual intolerances of foods, savouries and drugs. Three of them are associated with antiperistaltic phenomena in the upper gastrointestinal tract.