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. 2020 Aug 14;26(30):4523-4536.
doi: 10.3748/wjg.v26.i30.4523.

Predictive value of alarm symptoms in patients with Rome IV dyspepsia: A cross-sectional study

Zhong-Cao Wei  1 , Qian Yang  1 , Qi Yang  2 , Juan Yang  2 , Xin-Xing Tantai  1 , Xin Xing  1 , Cai-Lan Xiao  1 , Yang-Lin Pan  3 , Jin-Hai Wang  1 , Na Liu  4
Affiliations

Predictive value of alarm symptoms in patients with Rome IV dyspepsia: A cross-sectional study

Zhong-Cao Wei et al. World J Gastroenterol. .

Abstract

Background: No studies have evaluated the predictive value of alarm symptoms for organic dyspepsia and organic upper gastrointestinal (GI) diseases based on Rome IV criteria in the Chinese population.

Aim: To evaluate the predictive value of alarm symptoms for dyspeptic patients based on Rome IV criteria.

Methods: We performed a cross-sectional study of dyspepsia patients who met the inclusion and exclusion criteria at two academic urban tertiary-care centers from March 2018 to January 2019. Basic demographic data, dyspeptic information, alarm symptoms, lifestyle, examination results, family history and outpatient cost information were collected. Dyspepsia patients with normal findings on upper GI endoscopy, epigastric ultrasound and laboratory examination and without Helicobacter pylori-associated dyspepsia were classified as functional dyspepsia.

Results: A total of 381 patients were enrolled in the study, including 266 functional dyspepsia patients and 115 organic dyspepsia patients. There were 24 patients with organic upper GI disease among patients with organic dyspepsia. We found that based on the Rome IV criteria, alarm symptoms were of limited value in differentiating organic dyspepsia and organic upper GI diseases from functional dyspepsia. Age (odds ratio (OR) = 1.056, P = 0.012), smoking (OR = 4.714, P = 0.006) and anemia (OR = 88.270, P < 0.001) were independent predictors for organic upper GI diseases. For the comparison of epigastric pain syndrome, postprandial distress syndrome and epigastric pain syndrome combined with postprandial distress syndrome, the results showed that there were statistically significant differences in anorexia (P = 0.021) and previous visits (P = 0.012). The ClinicalTrials.gov number is NCT03479528.

Conclusion: Most alarm symptoms had poor predictive value for organic dyspepsia and organic upper GI diseases based on Rome IV criteria. Gastroscopic screening should not be based solely on alarm symptoms.

Keywords: Alarm symptoms; Dyspepsia; Prediction; Rome IV.

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Conflict of interest statement

Conflict-of-interest statement: There is no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study. GI: Gastrointestinal; Hp: Helicobacter pylori.
Figure 2
Figure 2
Endoscopy results.
See this image and copyright information in PMC

References

    1. Parkman HP, Camilleri M, Farrugia G, McCallum RW, Bharucha AE, Mayer EA, Tack JF, Spiller R, Horowitz M, Vinik AI, Galligan JJ, Pasricha PJ, Kuo B, Szarka LA, Marciani L, Jones K, Parrish CR, Sandroni P, Abell T, Ordog T, Hasler W, Koch KL, Sanders K, Norton NJ, Hamilton F. Gastroparesis and functional dyspepsia: excerpts from the AGA/ANMS meeting. Neurogastroenterol Motil. 2010;22:113–133. - PMC - PubMed
    1. Tack J, Carbone F. Functional dyspepsia and gastroparesis. Curr Opin Gastroenterol. 2017;33:446–454. - PubMed
    1. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, Stanghellini V. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–1479. - PubMed
    1. Talley NJ, Vakil NB, Moayyedi P. American gastroenterological association technical review on the evaluation of dyspepsia. Gastroenterology. 2005;129:1756–1780. - PubMed
    1. Saito YA, Locke GR, Almazar AE, Bouras EP, Howden CW, Lacy BE, DiBaise JK, Prather CM, Abraham BP, El-Serag HB, Moayyedi P, Herrick LM, Szarka LA, Camilleri M, Hamilton FA, Schleck CD, Tilkes KE, Zinsmeister AR, Talley NJ. Polymorphisms of 5-HTT LPR and GNβ3 825C>T and Response to Antidepressant Treatment in Functional Dyspepsia: A Study from The Functional Dyspepsia Treatment Trial. Am J Gastroenterol. 2017;112:903–909. - PubMed

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