Table 1

The Rome IV criteria for functional dyspepsia3

Diagnostic criteria for functional dyspepsia
One or more of the following:
  • Bothersome epigastric pain.

  • Bothersome epigastric burning.

  • Bothersome postprandial fullness.

  • Bothersome early satiation.

  • Symptom onset at least 6 months prior to diagnosis.

  • Symptoms should be active within the past 3 months.

  • And, no evidence of structural disease (including at upper endoscopy) likely to explain the symptoms.

Diagnostic criteria for epigastric pain syndrome (EPS) Diagnostic criteria for postprandial distress syndrome (PDS)
Must include one or both of the following symptoms at least 1 day a week.
  1. Bothersome epigastric pain (ie, severe enough to impact on usual activities).

  2. Bothersome epigastric burning (ie, severe enough to impact on usual activities).


Supportive criteria:
  1. Pain may be induced by ingestion of a meal, relieved by ingestion of meal or may occur while fasting.

  2. Postprandial epigastric bloating, belching and nausea can also be present.

  3. Persistent vomiting likely suggests another disorder;.

  4. Heartburn is not a dyspeptic symptom, but may often coexist.

  5. The pain does not fulfil biliary pain criteria.

  6. Symptoms that are relieved by evacuation of faeces or gas generally should not be considered as part of dyspepsia.

  7. Other digestive symptoms (such as gastro-oesophageal reflux disease and irritable bowel syndrome) may coexist with the EPS.

Must include one or both of the following symptoms at least 3 days a week:
  1. Bothersome postprandial fullness (ie, severe enough to impact on usual activities).

  2. Bothersome early satiation (ie, severe enough to prevent finishing a regular sized meal).


Supportive criteria:
  1. Postprandial epigastric pain or burning, epigastric bloating, excessive belching, and nausea can also be present.

  2. Vomiting warrants consideration of another disorder.

  3. Heartburn is not a dyspeptic symptom, but may often coexist.

  4. Symptoms that are relieved by evacuation of faeces or gas should generally not be considered as part of dyspepsia.

  5. Other individual digestive symptoms or groups of symptoms (such as gastro-oesophageal reflux disease and irritable bowel syndrome) may coexist with PDS.