A.Functional esophageal disease
A1.Functional heartburn
Must include all of the following conditions:
1, burning-like discomfort or pain behind the sternum.
2. No evidence of gastroesophageal acid reflux causing the symptom.
3. No histopathologically based esophageal motility disorder.
The symptoms were present for at least 6 months prior to diagnosis, and the above criteria were met in the last 3 months.
A2. Functional chest pain of presumed esophageal origin
All of the following conditions must be included:
1. Non-burning pain or discomfort behind the sternum.
2. No evidence of gastroesophageal acid reflux causing the symptom.
3. No histopathologically based esophageal motility disorder.
The symptoms were present for at least 6 months prior to diagnosis, and the above criteria were met in the last 3 months.
A3.Functional dysphagia
All of the following conditions must be included:
1, solid and/or liquid food passing through the esophagus with a sensation of adhesion, retention or abnormal passage.
2. No evidence of gastroesophageal acid reflux causing the symptom.
3. No histopathologically based esophageal motility disorder.
Symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met for the last 3 months.
A4. Hysterical bulbar syndrome
All of the following conditions must be included:
1.Persistent or intermittent painless mass or foreign body sensation in the larynx.
2.The sensation appears between meals.
3.No dysphagia or painful swallowing.
4, No evidence of gastroesophageal acid reflux causing the symptom.
5, No histopathologically based esophageal motility disorder.
The symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met in the last 3 months.
B. Functional gastroduodenal disease
B1.Functional dyspepsia
Must include
1. 1 or more of the following:
a. Postprandial fullness and distension
b.Sense of early satiety
c, epigastric pain
d. Burning sensation in the epigastrium
2.No functional disease that can explain the above symptoms.
The symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met in the last 3 months.
B1a postprandial discomfort syndrome
Must include 1 or 2 of the following:
1. Postprandial discomfort after eating a normal amount of food, occurring at least several times a week.
2. A feeling of early satiety that inhibits normal eating, occurring at least several times a week.
The symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met for the last 3 months.
Criteria supporting the diagnosis:
1. epigastric distention or postprandial nausea or excessive hiccups.
2. Possible coexistence of epigastric pain syndrome.
B1b epigastric pain syndrome
All of the following conditions must be included:
1. Moderate or greater epigastric pain or burning sensation, at least once a week.
2. Intermittent pain.
3, not total abdominal pain, not located in other parts of the abdomen or chest.
4.It cannot be relieved after defecation or exhaustion.
5.Does not meet the diagnostic criteria for gallbladder or sphincter of Oddi disease.
Symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met in the last 3 months.
Criteria supporting the diagnosis:
1, The pain may be burning-like but does not include retrosternal pain.
2. The pain is usually triggered or relieved by eating, but may also occur during fasting.
3. There may be a postprandial discomfort syndrome.
B2. Belching syndrome
B2a, Gas-swallowing
All of the following conditions must be included:
1. Recurrent belching occurs at least several times per week.
2. Air swallowing can be objectively observed or detected.
Symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met for the last 3 months.
B2b, Non-specific excessive belching
All of the following conditions must be included:
1. Recurrent belching occurs at least several times per week.
2. No evidence of excessive air swallowing.
The symptoms have been present for at least 6 months prior to diagnosis and the above criteria have been met for the last 3 months.
B3, Nausea and vomiting
B3a, chronic idiopathic nausea
All of the following must be included:
1. Nausea occurs at least several times per week.
2. Infrequent vomiting.
3. Absence of abnormalities on gastroscopy or metabolic disease that could explain the nausea.
The symptoms have been present for at least 6 months prior to diagnosis and the above criteria have been met for the last 3 months.
B3b, Functional vomiting
All of the following must be included:
1. Vomiting occurs on average 1 or more times per week.
2. No eating disorder, regurgitation, or major psychiatric illness (according to DSM-IV).
3. No self-induced or long-term cannabinoid application and no CNS or metabolic disorders that could explain the recurrent vomiting.
The symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met for the last 3 months.
B3c, cyclic vomiting syndrome
All of the following conditions must be included.
1. Recurrent acute episodes of the same vomiting symptoms, with each episode lasting no more than 1 week.
2. 3 or more intermittent episodes in the previous 1 year.
3. Absence of nausea and vomiting in the interictal period.
The symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met for the last 3 months.
Criteria to support the diagnosis:
History of migraine or family history.
B4. Ruminant syndrome
All of the following conditions must be included:
1. Persistent or repeated regurgitation of freshly eaten food into the mouth, followed by spitting out or re-chewing and swallowing.
2, no dry heaving before regurgitation.
The symptoms have been present for at least 6 months prior to diagnosis, and the above criteria have been met for the last 3 months.
Criteria supporting the diagnosis:
1, No nausea before regurgitation in general.
2. The process stops when the regurgitated material becomes acidic.
3. The regurgitated material is recognizable as food and does not have an unpleasant odor.
C. Functional intestinal diseases
C1.Irritable bowel syndrome
Repeated episodes of abdominal pain or discomfort, with symptoms occurring at least 3 days per month in the last 3 months, combining 2 or more of the following:
1. Relief of symptoms after defecation.
2. The attack is accompanied by a change in the frequency of bowel movements.
3.Changes in stool characteristics (appearance) during episodes.