Treatment Of Functional Dyspepsia Research Articles

Meta-analysis of Simotang Oral Liquid in treatment of functional dyspepsia in adults

This study was conducted to evaluate the efficacy and safety of Simotang Oral Liquid in the treatment of functional dyspepsia in adults. "Simotang Oral Liquid" "Simotang" "Si Mo Tang" "Si Mo Tang Oral Liquid" were used for retrieval of the relevant papers from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, Springer Link, and Web of Science from database inception to June 2021. Randomized controlled trial(RCT) of Simotang Oral Liquid in the treatment of functional dyspepsia in adults was screened out for Meta-analysis which was conducted in RevMan 5.3. A total of 16 RCTs were included. Meta-analysis showed that compared with the control group, Simotang Oral Liquid increased the total response rate and lowered the traditional Chinese medicine syndrome scores, serum cholecystokinin(CCK), serum nitric oxide(NO), and incidence of adverse reactions. However, the serum substance P(SP) had no statistical difference between the two groups. Simotang Oral Liquid is effective and safe in the treatment of functional dyspepsia in adults. However, this study has evidence and limitations, so the conclusions need to be further verified by large sample and multicenter clinical studies.

中医药联合心理疗法治疗功能性消化不良的研究进展

中医药联合心理疗法治疗功能性消化不良的研究进展

Progress of Chinese and Western medicine research on the treatment of functional dyspepsia based on intestinal microecology

Functional dyspepsia (FD) is a disease in which gastroparesis and diet-related symptoms are the main clinical manifestations due to the dysfunction of the gastroduodenum, but there are no structural changes and its pathogenesis is still unclear. In recent years, intestinal microecology has been confirmed to be related to FD. In this paper, we intend to review the role and mechanism of microecological agents and Chinese medicine in the treatment of functional dyspepsia, starting from the relationship between intestinal microecology and FD, in order to provide reference for clinical treatment and research.

Study of the potential mechanism of acupuncture treatment for functional dyspepsia based on association rule mining and bioinformatics/network pharmacology approach

Study of the potential mechanism of acupuncture treatment for functional dyspepsia based on association rule mining and bioinformatics/network pharmacology approach

The treatment of functional dyspepsia: present and future

ABSTRACT Introduction Functional dyspepsia (FD) is a prevalent, but frequently overlooked and/or under diagnosed disorder of gut-brain interaction (DGBI). Functional dyspepsia frequently co-exists with other DGBIs, and persistent symptoms have a significant impact on patients’ quality of life. A variety of therapies (e.g. diet, probiotics, antibiotics, acid suppressants, neuromodulators, prokinetics) are employed to treat the multiple symptoms of FD, although none are uniformly effective. Areas covered This review covers currently available therapies for the treatment of FD in addition to novel and emerging therapies that may change the treatment paradigm in the near future. PubMed, Embase and the Cochrane data bank were searched from 1990 to October 2022 for relevant articles. Expert opinion Dietary intervention, eradication of H. pylori, and/or a trial of acid suppression are reasonable initial treatment options for patients with FD. Neuromodulators and fundic accommodation agents are underemployed and should be used more routinely by healthcare providers, especially for patients with moderate-severe symptoms. Alternative therapies, such as cognitive behavioral therapy and hypnotherapy, are gaining recognition as safe and effective treatments for FD and can be used alone or in combination with medications. Virtual reality has the potential to significantly improve global FD symptoms.

Treatment of Functional Dyspepsia in Outpatients after COVID-19 Infection

Aim: to compare the efficacy of different therapeutic regimens for managing functional dyspepsia in outpatients after COVID-19 infection.Materials and methods. 42 post-COVID-19 outpatients (age: 26–47 years) diagnosed with functional dyspepsia (FD) according to the Rome IV Criteria were enrolled in two parallel groups. All patients were divided in 2 groups by randomization: Group 1 received omeprazole at a dose of 80 mg/day, Group 2 received a combination of omeprazole and Kolofort® (a combined action drug product containing technologically processed antibodies to S100, TNF-alpha, and histamine) at a dose of 80 mg/day. At baseline and after treatment, a 10-point VAS was used to measure symptoms and an SF-36 questionnaire to evaluate the quality of life.Results. By Day 28 of the treatment, the intensity of epigastric pain (VAS score) in the group receiving proton-pump inhibitor (PPI) + Kolofort® was significantly lower. In both groups, fully resolved dyspeptic syndrome was observed in up to 90 % of patients, without significant differences (p < 0.06). According to the SF-36 data, a combination treatment resulted in higher scores (pain and general health subscales) as compared to the PPI alone.Conclusion. Kolofort® relieves symptoms and improves the quality of life when added to the treatment regimen against functional dyspepsia in post-COVID-19 patients.

Chuna manual therapy in patients with functional dyspepsia: A protocol for systematic review and meta-analysis

Functional dyspepsia (FD) is a functional gastrointestinal disease that occurs without any explanatory organic disease, involving discomforts in upper abdomen such as bloating or pain after eating food. Although there is a standard treatment for FD, the disease often recurs or develops into a chronic condition, resulting in poor quality of life for the patients and high socioeconomic burden. Chuna therapy is a manual treatment commonly used in traditional Korean medicine (TKM) for musculoskeletal diseases such as intervertebral disc disorders and spinal stenosis. Recent studies have shown that Chuna therapy can be applied for the treatment of FD and is helpful in symptom improvement; however, high-quality evidence is still lacking. Therefore, this systematic review protocol intends to analyze the efficacy and safety of Chuna manual therapy for FD. We will search 11 electronic databases, including the Embase and MEDLINE, from their inception to June 2022. Two reviewers will independently screen the relevant studies and determine their compatibility with the search eligibility of this review. The primary outcome is the total clinical effective rate, and other variables such as dyspepsia-related symptom score, quality of life score, and adverse events will be analyzed. We will evaluate the quality of the evidence and interpret the overall findings using the Cochrane risk-of-bias tool for randomized trials and the Grading of Recommendations Assessment, Development, and Evaluation tool. To reduce the heterogeneity of the included studies, subgroup analysis according to the subdivisions of FD will be conducted and operational methods of Chuna therapy will be recorded in detail. This protocol describes the systematic review to establish scientific evidence of Chuna manual therapy in FD patients. We will categorize various types of Chuna therapy for providing guidelines that can be applied reproducibly in clinical practice.

Retracted: Clinical Effect of Acupuncture Combined with Traditional Chinese Medicine Application on the Treatment of Functional Dyspepsia in Children and the Influence on Serum 5-HT and NO Levels.

[This retracts the article DOI: 10.1155/2022/6800662.].

Priorities in choosing prokinetic for patients with functional dyspepsia: Focus on itopride

Functional dyspepsia is a widespread disease with many symptoms that reduce the patient's quality of life. The effectiveness of prokinetics, including in combination with proton pump inhibitors, has a high level of scientific evidence in the treatment of functional dyspepsia. The effectiveness of itopride hydrochloride is determined by a dual mechanism of action: antagonism to D 2-dopamine receptors and inhibition of acetylcholinesterase. The drug exceeds of metoclopramide and domperidone in safety in relation to cardiac and neurological disorders. Itopride hydrochloride is not expected to have pharmacokinetic interactions with other drugs metabolized by the CYP3A4 system. In addition to functional dyspepsia, itopride hydrochloride is indicated in the treatment of chronic gastritis, gastrointestinal symptoms associated with gastric dysmotility or delayed gastric emptying, such as bloating, rapid satiety, a feeling of fullness in the stomach after eating, pain or discomfort in the epigastric region, loss of appetite, heartburn, nausea and vomiting. The pharmacoeconomic analysis shows an advantage of Itopride-SZ in comparing of the direct cost of it with the original and several generic drugs. In this way, it allows recommend Itopride-SZ as an affordable drug for various cohorts of patients.

A Clinical Study on the Diagnosis and Observation of Functional Dyspepsia - Focused on Algometer

Objectives: This study aimed to determine whether comparing the pressure pain threshold (PPT) with an algometer before and after treatment for functional dyspepsia is of diagnostic value and investigate a possible correlation between PPT measured using an algometer and symptom improvement before and after treatment.Methods: A total of 99 patients with functional dyspepsia symptoms admitted to the OO Korean Medical Hospital from April 14, 2020 to January 21, 2021 were investigated. On the 1st and 14th days of hospitalization, the pressure of the first pain complaint at acupuncture points Juque (巨厥, CV14), Shangwan (上脘, CV13), Zhongwan (中脘, CV12), Xiawan (下脘, CV10), Guanuan (關元, CV4), Tianshu (天樞, ST25), and Daju (大巨, ST27) was measured using the algometer, and the visual analog scale (VAS) scores for patient’s symptoms were evaluated. The algometer PPT and patient-symptom VAS scores were compared by repeated measures corresponding to the sample t-test to analyze the changes after treatment. A correlation analysis was performed to identify the correlation between patient-symptom VAS scores and algometer PPT.Results: The PPT measured using the algometer significantly increased after treatment in the 99 patients. The patient-symptom VAS score decreased significantly in most cases as treatment progressed. Analysis of the correlation between algometer PPT and patient-symptom VAS scores revealed some notable negative correlations.Conclusion: The algometer can help to set the diagnostic and treatment baselines for patients with functional dyspepsia.

Comparison of the Effects of Oral Nizatidine versus Famotidine on Intragastric pH and Gastric Emptying in a Stress Rat Model

Background/Aims: Histamine-2 receptor antagonists (H2RA) are used to treat acid-related disorders and functional dyspepsia. In contrast to other H2RAs, nizatidine promotes gastric emptying (GE). We investigated the effects of nizatidine and famotidine on intragastric pH and the GE rate in rats exposed to stress.Materials and Methods: We used 8-week-old male Wistar rats. Based on administration of water or drugs after an overnight fast, the animals were categorized into the nonstress-water, stress-water, stress-nizatidine, stress-famotidine, and stress-nizatidine with mosapride groups. The rats had access to pre-weighed food for 10 minutes, and those in the stress groups were exposed to 1 hour of restraint stress. Intragastric pH was measured under isoflurane anesthesia, and the GE rate was measured after the rats were sacrificed.Results: The GE rate was significantly lower in the stress-water and stress-famotidine groups than in the nonstress-water group. However, GE in the stress-nizatidine and stress-nizatidine with mosapride group did not significantly differ from that in the nonstress- water group. The GE rate was significantly higher in the stress-nizatidine with mosapride than in the stress-famotidine group. Intragastric pH was significantly higher in the stress-nizatidine and stress-famotidine groups than in the stress-water group. Nonetheless, there was no significant difference in pH between the stress-nizatidine and stress-famotidine groups. The intragastric pH was slightly but significantly higher in the stress-nizatidine with mosapride group than in the stress-nizatidine and stress-famotidine groups.Conclusions: In contrast to famotidine, nizatidine prevents stress-induced GE delay, which suggests that nizatidine is superior to other H2RAs for treatment of functional dyspepsia associated with delayed GE.

The Impact of Duodenal Mucosal Vulnerability in the Development of Epigastric Pain Syndrome in Functional Dyspepsia.

An unidentified cause of functional dyspepsia (FD) is closely associated with medication resistance. Acid suppression is a traditional and preferential method for the treatment of FD, but the efficacy of this treatment varies between epigastric pain syndrome (EPS) and postprandial syndrome (PDS): it is efficient in the former but not much in the latter. Transepithelial electrical resistance (TEER), a surrogate of mucosal barrier function, was measured under pH 3 and pH 5 acidic conditions using duodenal biopsy specimens obtained from the patients with EPS and PDS and asymptomatic healthy controls. The infiltration of inflammatory cells to the duodenal mucosa was accessed by immunohistochemical analysis. The duodenal mucosal TEER in EPS patients was decreased by exposure to the acidic solution compared to that of the controls and the PDS patients. The decrease in TEER of the EPS patients was observed even under pH 5 weak acidic condition and was correlated to degree of the epigastric pain. Moreover, the duodenal mucosa of EPS patients presented an increase in mast cells and plasma cells that expressed Ig-E. Duodenal mucosal vulnerability to acid is likely to develop EPS.

Updates in functional dyspepsia and bloating.

Functional dyspepsia and bloating are common gastrointestinal conditions that frequently lead to gastroenterology referral. Both disorders have a significant negative impact on patients' quality of life and the healthcare system. The purpose of this review is to highlight important new findings in the cause, pathophysiology and treatment of these two disorders. Confocal laser endomicroscopy identified changes in epithelial barrier structure and function, providing important insights into the development of functional dyspepsia symptoms when combined with new observations of localized duodenal inflammation. Changes in the gut microbiome may be responsible for functional dyspepsia symptoms in some patients and may respond to gut-selective antibiotics. New data from the NIH-sponsored Gastroparesis Consortium confirmed that functional dyspepsia and gastroparesis are not distinct disorders but rather exist on a spectrum. Virtual reality may be a new therapeutic option for the treatment of functional dyspepsia. A novel questionnaire was developed and validated to assess symptoms, prevalence and impact in patients with bloating and distension. A meta-analysis identified medications to treat symptoms of bloating in patients with irritable bowel syndrome and constipation. Advances in our understanding of the pathophysiology of functional dyspepsia and bloating are leading to important changes in medical therapies.

External treatment of traditional Chinese medicine for functional dyspepsia in children: Protocol for a systematic review and network meta-analysis.

Functional dyspepsia (FD) is a common digestive system disease in pediatrics, usually affects normal growth and increases health care expenditure. Many investigations have demonstrated that external treatment of traditional Chinese medicine (TCM) has certain advantages in the treatment of FD children, but the effectiveness, safety, and advantages of various methods have not been confirmed by high-quality meta-analyses. This study will conduct a systematic review and network meta-analysis to evaluate the differences and effectiveness in external treatments of TCM, in order to provide a reference for further clinical treatment for FD in children. Nine electronic databases, including PubMed, Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, Wan-Fang Database and one clinical trial register platforms: ClinicalTrials.gov (www.ClinicalTrials.gov/) will be searched using English and Chinese search strategies. All eligible studies are randomized controlled trials of TCM external treatment for FD in children, published on or before July 20, 2022. The screening process will be developed by 2 independent authors, and network meta-analysis will be performed with RevMan (V5.3) software. This study will provide a high-quality synthesis to assess the effectiveness and safety on the external treatment of TCM for children with FD. The results of this study will provide evidence to judge whether the external treatment of TCM are effective interventions for children with FD. The results of this meta-analysis and meta-regression will be disseminated through publication in a peer-reviewed journal and presented at a relevant conference. The information used in the network meta-analysis does not contain individual patient data. Therefore, ethical approval was not required. CRD42022360429.

"Case Report: Novel Treatment for Functional Dyspepsia Combined Drugs and Psychosomatic Therapy"

"Case Report: Novel Treatment for Functional Dyspepsia Combined Drugs and Psychosomatic Therapy"

Effectiveness and tolerability of Poliprotect, a natural mucosal protective agent for gastroesophageal reflux disease and dyspepsia: Surveys from patients, physicians, and pharmacists

Background: Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are very common in the general population. GERD prevalence is considerably high in pregnant women, and it increases at a young age, alongside obesity. Mucosal protective agents (MPAs) are over-the-counter (OTC) treatments for FD and GERD commonly used alone or as add-on therapy to proton pump inhibitors (PPIs). Real-world data through surveys allow a clinical evaluation of marketed products that also complies with the new regulation on substance-based medical devices (SBMDs).Aim: The study aimed to evaluate perceived effectiveness, safety, and pattern of usage among patients, physicians, and pharmacists of the natural MPA Poliprotect, as assessed by a validated survey methodology.Methods: Questionnaire repeatability was first assessed, resulting in the intraclass correlation coefficient agreement level >0.9 in the three validation cohorts of physicians, pharmacists, and patients. All questions were closed multiple-choice, allowing measuring variations in frequency, quality, or magnitude of effect on a 5-point Likert-like verbal scale.Results: Three different surveys were performed in Italy and Spain on a total of 3,471 physicians, including 77 gastroenterologists, 848 patients, and 146 pharmacists who had an experience with Poliprotect in the previous year. Over 90% of general practitioners (GPs) rated Poliprotect effectiveness as good/excellent in controlling pyrosis, 80% for epigastric pain, and approximately 70% for digestion difficulties. GPs reported Poliprotect as very or extremely useful as an alternative to PPIs (73%) and for pregnancy-associated GERD symptoms (61%), almost unanimously (99.5%) reporting an excellent to good tolerability; 79% of the gastroenterologists answered to be extremely or very satisfied with the improvement of typical GERD symptoms, whereas improvement of dyspepsia and pregnancy- and breast-feeding-associated GERD symptoms was rated as highly satisfactory for 69, 52, and 62%, respectively, among GI specialists. Its use because of painful dyspeptic symptoms was reported by over 80% of patients, who rated symptom relief as excellent/good, and reported a marked quality-of-life improvement in 73% and in 65% of their answers, respectively. The product was used as monotherapy by 63% of patients. Conclusion: Large-scale, validated surveys support the safety and effectiveness of Poliprotect in the treatment of common functional upper GI disorders.

S514 Virtual Reality Improves Symptoms of Functional Dyspepsia: Results of a Randomized, Controlled, Double-Blind Pilot Study

Introduction: Functional dyspepsia (FD) is a common functional GI disorder, characterized by symptoms of abdominal pain, nausea, and/or early satiety. Virtual reality (VR) is a promising intervention which has been shown to alleviate pain in various clinical settings. There are currently no studies assessing VR for the treatment of FD. The aim of this study was to investigate the effectiveness and safety of VR for the treatment of FD. Methods: This is a prospective, single-center, randomized, controlled, double-blinded study of adult patients with FD (Rome IV criteria). Enrolled patients were randomized 2:1 (experimental to control). Experimental patients were given a VR headset with software consisting of immersive audiovisual programs. Control patients were given an identical headset with 2-D nature videos. Patients were asked to use their headset at least daily and completed Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and Nepean Dyspepsia Index (NDI) questionnaires at their initial visit, after 1 week of use, and at the conclusion of the 2-week study. Paired sample t-tests were used to compare questionnaire scores. Results: Thirty-seven patients were enrolled in the study (27 experimental, 10 controls); demographic data are shown in Table (Table). Patients used the VR headset an average of 1.3 times/day for a mean of 23.2 minutes/day. Total PAGI-SYM scores significantly decreased for all patients [2.51 (baseline) to 0.62 (week 2); p=0.000]. Notably, patients in the experimental group had greater improvement in mean total PAGI-SYM scores [2.51 baseline) to 1.83 (week 2); mean difference -0.68; p=0.000], compared to the control group [2.50 (baseline) to 2.04 (week 2); mean difference -0.46; p=0.046]. Further, quality of life (QoL) significantly improved for all patients, as the total NDI QoL score increased from 40.97 (baseline) to 57.14 (week 2), p=0.000, though experimental patients saw greater improvement in QoL, compared to control patients (Figure). Seventeen patients (45.9%; 11 experimental, 6 controls) reported non-serious adverse effects (AE), with headache and dizziness being the most common; 1 experimental patient withdrew due to AEs (migraines). Conclusion: In the first randomized, controlled, double-blind study to assess VR for the treatment of FD, VR was shown to be safe and result in statistically significant overall improvement in symptoms and QoL in FD patients. We propose VR as a novel treatment for FD worthy of further investigation.Figure 1.: Total PAGI-SYM and NDI Quality of Life Scores Table 1. - Study Population Demographic Data Mean Age 45 years (± 14) Mean BMI 24.56 (± 6.79) SexFemaleMale 30 (81.1%)7 FD subtypeEPSPDSMixed EPS/PDS 12 (32.4%)20 (54.1%)5 (13.5%) Anxiety 17 (45.9%) Depression 9 (24.3%) PTSD 2 (5.4%) Fibromyalgia 4 (10.8%) Prior H. pylori infection 5 (13.5%) MedicationsPPIAntidepressantsGabapentinOpioidsNSAIDs 16 (43.2%)11 (29.7%)4 (10.8%)2 (5.4%)0 Alcohol Use 7 (18.9%) Marijuana Use 4 (10.8%)

Effect of different acupuncture and moxibustion methods on functional dyspepsia caused by sequelae of COVID-19: A protocol for systematic review and meta-analysis.

Background:Functional dyspepsia (FD) is a group of diseases that cannot be explained after routine clinical examination, and is characterized by postprandial fullness, early satiety, and upper abdominal pain or burning. According to the statistics, FD continues to become one of the high-risk sequelae of coronavirus disease 2019 (COVID-19), affecting patients’ quality of life, increasing psychological burden and increasing economic costs. However, its optimal treatment is still an urgent problem. A large number of studies have shown that acupuncture and moxibustion is effective and safe in the treatment of FD caused by sequelae of COVID-19, which is of research value. Therefore, based on the current literatures, the effectiveness and safety of different acupuncture and moxibustion methods were systematically evaluated to provide possible alternative therapy on FD.Methods:Studies search for eligible randomized controlled trials that use different acupuncture and moxibustion methods as the sole treatment on FD and their data extraction will be done by 2 researchers. In case of disagreement, a third researcher will be introduced for arbitration. Mean difference or relative risk with fixed or random effect model in terms of 95% confidence interval will be adopted for the data synthesis. To evaluate the risk of bias, the Cochrane risk of bias assessment tool will be utilized. The sensitivity or subgroup analysis will also be conducted when meeting high heterogeneity (I2 > 50%).Results:This meta-analysis will provide an authentic synthesis of different acupuncture and moxibustion methods on FD caused by sequelae of COVID-19.Conclusion:This meta-analysis will evaluate the effect of acupuncture and moxibustion on FD caused by sequelae of COVID-19, providing evidence as to the treatment in these patients.

Deqi Sensation to Predict Acupuncture Effect on Functional Dyspepsia: A Machine Learning Study.

Objectives The aim of the study was to predict the effect of acupuncture for treating functional dyspepsia (FD) using the support vector machine (SVM) techniques based on initial deqi sensations of patients. Methods This retrospective study involved 90 FD patients who had received four weeks of acupuncture treatment. The support vector classification model was used to distinguish higher responders (patients with Symptom Index of Dyspepsia improvement score ≥ 2) from lower responders (patients with Symptom Index of Dyspepsia improvement score < 2). A support vector regression model was used to predict the change in the Symptom Index of Dyspepsia at the end of acupuncture treatment. Deqi sensations of patients in the first acupuncture treatment of a 20-session acupuncture intervention were defined as features and used to train models. Models were validated by 10-fold cross-validation and evaluated by accuracy, specificity, sensitivity, the area under the receive-operating curve, the coefficient of determination (R2), and the mean squared error. Results The two models could predict the efficacy of acupuncture successfully. These models had an accuracy of 0.84 in predicting acupuncture response, and an R2 of 0.16 in the prediction of symptom improvements, respectively. The presence or absence of deqi sensation, the duration of deqi sensation, distention, and pain were finally selected as significant predicting features. Conclusion Based on the SVM algorithms and deqi sensation, the current study successfully predicted the acupuncture response as well as clinical symptom improvement in FD patients at the end of treatment. Our prediction models are expected to promote the clinical efficacy of acupuncture treatment for FD, reduce medical expenditures, and optimize the allocation of medical resources.

Complementary and alternative medicine for functional dyspepsia: An Asian perspective

A considerable number of Asian patients with functional dyspepsia (FD) are searching for complementary and alternative medicine (CAM) because they are unsatisfied with conventional medical treatment. However, no article has focused on CAM for FD from Asian perspective. In Asian countries, many traditional herbal formulas, including Banha-sasim-tang, Soyo-san, Sihosogan-san, Yukgunja-tang, and Pyeongwi-san, are used in patients with FD. In the few blinded and placebo-controlled studies conducted, the weak evidence regarding the effectiveness of herbal prescriptions in patients with FD did not allow any conclusions to be made. The clinical efficacy and safety of STW-5 were proven in several prospective randomized controlled trials and systematic reviews. Hence, it was recently approved as a therapeutic option for the treatment of FD. Peppermint and caraway, FDgard, black seed oil, and Jollab have been used in patients with FD, but there is limited evidence supporting their use. Reviews of acupuncture in patients with FD showed inconsistent results: a Cochrane review reported a negative result, while other meta-analyses reported positive results. Psychotherapy, including hypnotherapy, psychoanalytic psychotherapy, and cognitive behavioral therapy, may be used in patients with FD, although it is only supported by weak evidence. Therefore, well-planned, large-scale studies are necessary to evaluate the efficacy of CAM in treating FD, especially in Asian countries.