Unifying Concepts

Rome III Criteria for Functional Dyspepsia (FD)

According to the Rome III criteria, functional dyspepsia is defined as the presence of one or more of the following: postprandial fullness, early satiation, epigastric pain or burning and no evidence of structural disease (including at upper endoscopy) to explain the symptoms.

Rome III Criteria for Functional Dyspepsia (FD)
Patients must have had one or more of the following symptoms for the past 3 months with symptom onset at least 6 months prior to diagnosis:

  • Postprandial fullness
  • Early satiety
  • Epigastric burning

As well as no evidence of structural disease that is likely to explain symptoms (including any condition detected by upper endoscopy)
A. Postprandial distress syndrome
Diagnostic criteria must include the following:

  • Bothersome postprandial fullness, occurring after ordinary-sized meals, at least several times per week
  • Early satiation that prevents finishing a regular meal, at least several times per week

Other symptoms may include:

  • Upper abdominal bloating or postprandial nausea or excessive belching
  • Epigastric pain syndrome may coexist

B. Epigastric pain syndrome
Diagnostic criteria must include all of the following:

  • Pain or burning localized to the epigastrium, of at least moderate severity at least once per week
  • Pain is intermittent
  • Pain is not generalized or localized to other abdominal or chest regions
  • Pain is not relieved by defecation or passage of flatus
  • Pain does not fulfill criteria for biliary pain

Other symptoms may include:

  • Epigastric pain of a burning quality, but without a retrosternal component
  • Pain induced or relieved by ingestion of a meal, but which also may occur while fasting

Postprandial distress syndrome may coexist



  1. Fang YJ, Liou JM, Chen CC, Lee JY, Hsu YC, Chen MJ, Tseng PH, Chen CC, Chang CY, Yang TH, Chang WH, Wu JY, Wang HP, Luo JC, Lin JT, Shun CT, Wu MS; Taiwan Gastrointestinal Disease and Helicobacter Consortium. Distinct aetiopathogenesis in subgroups of functional dyspepsia according to the Rome III criteria. Gut. 2015 Oct;64(10):1517-28. [Medline]
  2. Ford AC, Bercik P, Morgan DG, Bolino C, Pintos-Sanchez MI, Moayyedi P. The Rome III criteria for the diagnosis of functional dyspepsia in secondary care are not superior to previous definitions. Gastroenterology. 2014 Apr;146(4):932-40. [Medline]


Created Nov 19, 2015.

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