Effects and mechanisms of acupuncture and electroacupuncture for functional dyspepsia: A systematic review

Table 1 Rome IV criteria for functional dyspepsia

Functional dyspepsia diagnostic criteria12
One or more of the following:
Bothersome postprandial fullness
Bothersome early satiation
Bothersome epigastric pain
Bothersome epigastric burning
AND
No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms
Postprandial distress syndrome diagnostic criteria2
Must include one or both of the following at least 3 d per wk:
Bothersome postprandial fullness (i.e. severe enough to impact on usual activities)
Bothersome early satiation (i.e. severe enough to prevent finishing a regular-size meal)
No evidence of organic, systemic, or metabolic disease that is likely to explain the symptoms on routine investigations (including at upper endoscopy)
Supportive remarks:
Postprandial epigastric pain or burning, epigastric bloating, excessive belching, and nausea can also be present
Vomiting warrants consideration of another disorder
Heartburn is not a dyspeptic symptom but may often coexist
Symptoms that are relieved by evacuation of feces or gas should generally not be considered as part of dyspepsia
Other individual digestive symptoms or groups of symptoms, e.g., from gastroesophageal reflux disease and the irritable bowel syndrome may coexist with PDS
Epigastric pain syndrome diagnostic criteria2
Must include at least 1 of the following symptoms at least 1 d a week:
Bothersome epigastric pain (i.e. severe enough to impact on usual activities)
AND/OR
Bothersome epigastric burning (i.e. severe enough to impact on usual activities)
No evidence of organic, systemic, or metabolic disease that is likely to explain the symptoms on routine investigations (including at upper endoscopy)
Supportive remarks:
Pain may be induced by ingestion of a meal, relieved by ingestion of a meal, or may occur while fasting
Postprandial epigastric bloating, belching, and nausea can also be present
Persistent vomiting likely suggests another disorder
Heartburn is not a dyspeptic symptom but may often coexist
The pain does not fulfill biliary pain criteria
Symptoms that are relieved by evacuation of feces or gas generally should not be considered as part of dyspepsia
Other digestive symptoms (such as from gastroesophageal reflux disease and the irritable bowel syndrome) may coexist with EPS

¹Must fulfill criteria for B1a. Postprandial distress syndrome and/or epigastric pain syndrome.

²Criteria fulfilled for the last 3 mo with symptom onset at least 6 mo before diagnosis. EPS: Epigastric pain syndrome; PDS: Postprandial distress syndrome.