In the Asia-Pacific functional GI disorders studies, epigastric pain and bowel symptoms, as a symptom cluster, would have fulfilled the Rome criteria for epigastric pain syndrome (EPS) and irritable bowel syndrome (IBS). The bowel symptom can be affected by food, associated with bowel movement and passing gas, and also with changes in stool form and frequency. Epigastric pain can be present in approximately 30-50% of patients with IBS. The putative pathophysiology may include referred visceral pain to the epigastrium, exaggerated gastrocolic reflex, and duodenal dysfunction. Possible treatment options may include anti-spasmodic agents, tricyclic agents, and dual histamine blockade.