Tack Jan, Talley Nicholas J, Camilleri Michael, Holtmann Gerald, Hu Pinjin, Malagelada Juan-R, Stanghellini Vincenzo
Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium.
Gastroenterology. 2006 Apr;130(5):1466-79. doi: 10.1053/j.gastro.2005.11.059.
A numerically important group of patients with functional gastrointestinal disorders have chronic symptoms that can be attributed to the gastroduodenal region. Based on the consensus opinion of an international panel of clinical investigators who reviewed the available evidence, a classification of the functional gastroduodenal disorders is proposed. Four categories of functional gastroduodenal disorders are distinguished. The first category, functional dyspepsia, groups patients with symptoms thought to originate from the gastroduodenal region, specifically epigastric pain or burning, postprandial fullness, or early satiation. Based on recent evidence and clinical experience, a subgroup classification is proposed for postprandial distress syndrome (early satiation or postprandial fullness) and epigastric pain syndrome (pain or burning in the epigastrium). The second category, belching disorders, comprises aerophagia (troublesome repetitive belching with observed excessive air swallowing) and unspecified belching (no evidence of excessive air swallowing). The third category, nausea and vomiting disorders, comprises chronic idiopathic nausea (frequent bothersome nausea without vomiting), functional vomiting (recurrent vomiting in the absence of self-induced vomiting, or underlying eating disorders, metabolic disorders, drug intake, or psychiatric or central nervous system disorders), and cyclic vomiting syndrome (stereotypical episodes of vomiting with vomiting-free intervals). The rumination syndrome is a fourth category of functional gastroduodenal disorder characterized by effortless regurgitation of recently ingested food into the mouth followed by rechewing and reswallowing or expulsion. The proposed classification requires further research and careful validation but the criteria should be of value for clinical practice; for epidemiological, pathophysiological, and clinical management studies; and for drug development.
在患有功能性胃肠疾病的患者中，有相当一部分人的慢性症状可归因于胃十二指肠区域。基于一个国际临床研究人员小组审查现有证据后达成的共识意见，提出了功能性胃十二指肠疾病的分类。功能性胃十二指肠疾病分为四类。第一类是功能性消化不良，包括那些症状被认为源自胃十二指肠区域的患者，具体表现为上腹部疼痛或烧灼感、餐后饱胀或早饱。基于近期证据和临床经验，针对餐后不适综合征（早饱或餐后饱胀）和上腹部疼痛综合征（上腹部疼痛或烧灼感）提出了亚组分类。第二类是嗳气障碍，包括吞气症（伴有观察到的过度吞气的烦人的反复嗳气）和未明确的嗳气（无过度吞气证据）。第三类是恶心和呕吐障碍，包括慢性特发性恶心（频繁出现烦人的恶心但无呕吐）、功能性呕吐（在无自我诱导呕吐、潜在饮食失调、代谢紊乱、药物摄入或精神或中枢神经系统疾病的情况下反复呕吐）和周期性呕吐综合征（刻板的呕吐发作且有无呕吐间期）。反刍综合征是功能性胃十二指肠疾病的第四类，其特征是近期摄入的食物不费力地反流到口腔，随后重新咀嚼并重新吞咽或吐出。所提出的分类需要进一步研究和仔细验证，但这些标准对临床实践、流行病学、病理生理学和临床管理研究以及药物开发应该是有价值的。
