The following symptoms and complaints may indicate functional dyspepsia (irritable stomach syndrome; dyspeptic complaints):
Leading symptoms
- Belching / excessive air burping
- Feeling of pressure in the stomach (gastric pressure)/postprandial (“after eating”) fullness.
- Crampy abdominal discomfort (abdominal pain), possibly also as epigastric fasting pain.
- Nausea (nausea)/vomiting
- Feeling of fullness or early satiety
The discomfort often occurs after eating (postprandial distress syndrome; discomfort after eating) and has an irregular appearance.
The patient localizes the discomfort in the upper abdomen (between the umbilicus and xiphoid process) and laterally.
Based on the leading symptoms, functional dyspepsia can be divided into two subgroups (clusters) according to the Rome IV consensus (see classification below for details):
- Epigastric pain syndrome (EPS) – epigastric pain and burning sensation independent of meals.
- Postprandial distress syndrome (PDS) – food intake induced or increased feeling of fullness, nausea and early feeling of satiety.
According to Rome IV consensus, symptoms from both clusters can exist simultaneously
Characterization of dyspepsia based on symptoms.
| Dysmotility type (“dysmotility-like” dyspepsia). | Reflux type | Ulcer type (“ulcer-like” dyspepsia) |
| Feeling of pressure and fullness | Heartburn | Epigastric pain (upper abdominal pain) |
| Meteorism (bloated abdomen) | Retrosternal pain (pain behind the breastbone) | Fasting pain |
| Premature satiety | Morning hoarseness (laryngitis gastrica/laryngitis due to reflux of gastric acid) | |
| Nausea (sickness) |
Notice: In 20% to 30% of cases, a causative disease is present in patients with dyspepsia after diagnostic workup of the complaint symptoms.
