Functional Dyspepsia and Its Subgroups: Prevalence and Impact in the Rome IV Global Epidemiology Study

Background: Functional dyspepsia (FD) is one of the most common disorders of gut–brain interaction (DGBI). Varying reported population prevalences probably reflect different definitions and methodological approaches. Aim: To study the prevalence and impact of FD and its subgroups in an internet survey. Methods: A total of 54,127 respondents from 26 countries completed the survey including the Rome IV diagnostic questionnaire, Patient Health Questionnaire-4 (PHQ-4), PHQ-12, PROMIS Global-10, demographics, and medical history. Respondents reporting a history of relevant organic disease, or fulfilling criteria for self-induced or cyclic vomiting, or cannabinoid hyperemesis were excluded. Results: Rome IV FD prevalence was 7.2% (range 2.2%–12.3%), significantly higher in women and decreased with age. The most prominent subtype was postprandial distress syndrome (PDS) (66.6%). Rome IV IBS was found in 26.1% of those fulfilling FD criteria. Functional heartburn and chronic nausea and vomiting criteria were fulfilled in, respectively, 9.0% and 7.0%. Fulfilling FD symptom criteria was significantly associated with increased prevalence of anxiety and depression and with lower quality of life and higher healthcare seeking behaviour. Conclusions: Rome IV FD is one of the most prevalent DGBI globally. Across countries, it is associated with female sex, younger age, psychological distress, reduced quality of life, and higher health care utilisation. PDS is the dominant subgroup. Overlapping other DGBI are present in a minority.