Treatment options for patients with overlap of functional dyspepsia and irritable bowel syndrome

Abstract

Оbjective — to study the characteristics of changes in intestinal dysbiosis and psychoemotional status in patients with overlap of functional dyspepsia (FD) and irritable dowel syndrome (IBS) and to evaluate the efficacy of peppermint oil application in the treatment of such patients.
 Materials and methods. Examinations involved 92 patients with overlap of FD and IBS, from them 35 (38.0 %) men and 57 (62.0 %) women. Young patients (up to 45 years old) prevailed: 72 subjects (78.3 %). Epigastric pain syndrome was detected in 12 (13.0 %) patients, postprandial distress syndrome in 21 (22.8 %) patients, and 59 (64.1 %) patients had a mixed FD form. IBS with alternating constipation and diarrhea was diagnosed in 51 out of 59 (86.4 %) patients with the mixed FD form. Psychological testing was conducted to assess the psycho‑emotional status. The HADS scale was used to detect anxiety‑depressive disorders. Before and after treatment, all patients completed the SF‑36 quality of life (QoL) questionnaires. To diagnose the condition of the intestinal microbiota, presence of bacterial intestinal overgrowth syndrome (SIBO) was determined with the use of a hydrogen breath test with lactulose loading.
 Results. The use of the drug «Capsumen» in the complex treatment of patients with FD and IBS contributed to a rapid decrease in the intensity of abdominal pain (AP) (p < 0.05). In addition to positive clinical dynamics and AP relief, normalization of the intestinal microbiome was found in the patients. The SIBO frequency in patients who received «Capsumen» significantly decreased compared to the initial indexes and did not significantly differ from the data of healthy individuals. In all patients with FD and IBS, on the background of therapy, quality of life increased and anxiety‑depressive disorders decreased, compared to the data before treatment (p < 0.05).
 Conclusions. The use of peppermint oil in patients with FD and IBS demonstrated to be efficient and safe. The decrease in the abdominal pain frequency and intensity has been registered, in combination with the positive effects on the intestinal microbiome and normalization of quality of life, and minimizing anxiety‑depressive disorders.