Background: Prokinetic agents have shown variable efficacy in the treatment of functional dyspepsia. Mosapride is a new prokinetic 5‐hydroxytryptamine‐4 agonistic agent. Aim: To evaluate the efficacy of three dosage regimens of mosapride compared with placebo in the treatment of functional dyspepsia. Methods: Patients were randomly allocated to treatment with placebo or mosapride (5 mg b.d., 10 mg b.d. or 7.5 mg t.d.s.) in a double‐blind, prospective, multicentre, multinational study. The change in symptom severity score from an untreated baseline week to the sixth week of treatment was used to compare treatment efficacy. Results: There were 141, 140, 143 and 142 patients valid for evaluation in the intention‐to‐treat population in the placebo, mosapride 5 mg b.d., mosapride 10 mg b.d. and mosapride 7.5 mg t.d.s. groups, respectively. The mean changes in the overall dyspeptic symptom score were – 0.90, – 0.94, – 0.88 and – 0.89, respectively, and the proportions of patients feeling better at the end of the treatment period were 60%, 59%, 59% and 61%, respectively. No statistically significant difference was seen. Conclusions: Treatment of functional dyspepsia with mosapride was not superior to placebo. The result raises the question of whether treatment with prokinetic agents is appropriate for functional dyspepsia.
of reflux disease and reflux esophagitis. Scand J Gaatroenterol 1989, 2+ (suppl 156). 7-13Symptomatic gastroesophageal reflux is a cominou medical problem. But only few data exist on the epidemiology of reflux disease (without iidammation) mid reflux esophagitis. The literature is critically reviewed and ecological causes of gastroesophageal reflux are dibcussed. The prevalence of reflux esophagitis in Westrim countries i s estimated to be 2 Yo and that of reflux disease 5 Yo. Sparse reports exist on the natural history of both tliseabes. T h y appear to have little if any effect on life expectancy. The main rnmplicatioiis of reflux esophagitis are Barrett's esophapua, peptir stricture, ulceration end bleeding. K qwords. Complications: epidemiology: incidence; lethality: mortality; natural histor! : prevalence: reflux disease: reflox esophagitis Profebsor Dr. Martiii Wirnberk. Deparimmt of Internal Medicine III~ Zentralklini-kurJ1. 0-8900 .411gSbtUg. FRC Scand J Gastroenterol Downloaded from informahealthcare.com by Monash University on 09/16/13 For personal use only. 178, 117-120 PS. H e l~ Chir A~t a 1974, 41, 109-113 Scand J Gastroenterol Downloaded from informahealthcare.com by Monash University on 09/16/13 For personal use only. Scand J Gastroenterol Downloaded from informahealthcare.com by Monash University on 09/16/13For personal use only.
SUMMARY Previous investigations of stress effects on gastric emptying, orocaecal, and colonic transit in rats have produced conflicting results. Here one type of stressor, a 'passive avoidance' situation, was used to investigate its effects on gastric emptying, orocaecal and colonic transit. After the rats had been trained to eat a standard amount of semisolid food, gastric emptying was determined (n=12) by the food remaining in the stomach after various periods of rest, or stress exposure. Orocaecal transit (n=14) was determined by breath hydrogen measurements after the food had been labelled with 1 g lactose. Colonic transit (n=18) was measured as the arrival time of coloured faeces after infusion of a carmine red solution into the caecum through a chronically implanted catheter. The stressor had differential effects on transit through the stomach, small bowel and colon: gastric emptying was delayed (p<005) after stress (t/2=2.66 h after stress, 1.97 h at rest). Orocaecal transit was accelerated (p<005) after stress; transit time decreased from 124.3 min at rest to 86-2 min after stress. Colonic transit was accelerated (p<001) under stress, from 15X5 h to 1X29 h. It is concluded that gastrointestinal transit in different parts of the gastrointestinal tract is differently affected by central nervous stimuli.
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