In a Japanese study that considered 50 years as the cut-off age, frequency of FD was found to be lower among persons older than 50 years.29 In another study from Japan, of 1730 gastric cancer patients, 27 were less than 34 years old.30 A study from India showed that patients with gastric cancer were older than patients with non-ulcer dyspepsia (53 ± 12 years vs 43 ± 13 years).31 These data might suggest that the
cut-off age for considering endoscopic examination may vary by geographical area, though most believe that it should be 45 years of age. Statement 9. A portion of Asian patients with functional dyspepsia has overlapping irritable bowel syndrome. Grade of evidence: moderate. Level of agreement:
a: 100.0%; b: 0%; c: 0%; d: 0%; e: 0%; f: 0%. In Asian patients, there is a significant selleck inhibitor overlap between FD and IBS. In a Chinese study using the Rome III criteria, 24.8% of FD patients had overlapping IBS.8 In a study from India, dyspepsia-IBS overlap (dyspepsia was defined as abdominal pain or discomfort centered in the upper abdomen and IBS by Manning’s criteria) was found in 14.2% of the FD subjects.32 Another Indian multi-center study demonstrated a high frequency (90%) of upper abdominal pain or discomfort in IBS patients, although the diagnosis in that study was based on the clinicians’ assessment rather than on the Rome criteria.33 In a Japanese study, the overlap of FD and IBS was found to be 3.5%
of the patients with FD.34 In a study from Hong Kong selleckchem using the Rome I criteria, overlapping IBS was found to be 16.9% of the subjects with dyspepsia.35 In a Japanese study using the Rome II criteria for the diagnosis eltoprazine of functional GI disorders, 181 medical students were recruited, and the overlap of IBS was found to be 66.7% of UD subjects.36 In a Korean study of 476 patients with functional GI disorders according to the Rome II criteria, the overlap of IBS was found in 20.8% of FD patients.26 In these studies, overlap of FD and IBS showed wide variation that might be due to diagnostic criteria, study populations, sociocultural issues, or symptom reporting by the patients. Statement 10. Patients with functional dyspepsia may have overlap with gastroesophageal reflux disease. Grade of evidence: moderate. Level of agreement: a: 84.2%; b: 15.8%; c: 0%; d: 0%; e: 0%; f: 0%. Overlap of FD and gastroesophageal reflux disease (GERD) is common in different Asian populations.23 A study from Turkey showed overlap of GERD to be 29.4% of subjects with symptoms of dyspepsia,37 and a study from Korea showed such overlap to be 24.1% of FD subjects.38 In both of those studies, GERD was diagnosed by questionnaire and not by 24-h pH-impedance monitoring, which is currently the gold standard for diagnosis of GERD.