A randomized placebo‐controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia

Holtmann, Gerald; Gschossmann, Juergen M.; Mayr, P.; Talley, NJ

doi:10.1046/j.1365-2036.2002.01322.x

Cited by 83 publications

(39 citation statements)

References 28 publications

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“…[158][159][160] Simethicone is ineffective as monotherapy but has been found to produce additive effect on IBS symptoms in combination with other compounds. [161][162][163] Depending on predominant symptoms, a combination of these compounds can be of value in patients with IBS.…”

Section: Discussionmentioning

confidence: 99%

Irritable bowel syndrome, the microbiota and the gut-brain axis

Raskov¹,

et al. 2016

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Irritable bowel syndrome is a common functional gastrointestinal disorder and it is now evident that irritable bowel syndrome is a multi-factorial complex of changes in microbiota and immunology. The bidirectional neurohumoral integrated communication between the microbiota and the autonomous nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brainaxis, and possible treatment modalities on irritable bowel syndrome. The integrated actions and communication between the microbiota and the autonomous nervous system are central players in the perpetuation of IBS symptoms. This signaling pathway is called the GutBrain Axis (GBA). The GBA is a bidirectional neurohumoral communication system that integrates brain and GI functions, such as gut motility, appetite and weightand here the microbiota plays a critical role. 2Changes in gastrointestinal or central nervous system physiology may result in an altered habitat, which again may cause changes in the composition of the microbiota.Disruption of the physiologic symbiotic relationship (eubiosis) between the human host and the microbiota is called dysbiosis and is regarded a basic factor for initiating and maintaining IBS in the majority of patients. Current evidence has suggested that the dysbiosis observed in IBS and the resulting immunological response may drive and perpetuate gastrointestinal symptoms of IBS suggesting that IBS is in fact a disorder of the microbiota and the GBA. It is unclear whether the initiating factor is brain abnormalities that drive the gut changes or if changes in the gut alter brain function through vagal and sympathetic pathways.3,4 The purpose of this article is to review recent research concerning the influence of microbiota and gut-brain-axis on IBS. IBSIt is estimated that approximately 10% of the World population and 15% of the population in the Western World suffer from IBS characterized by a mixture of recurrent abdominal pain, bloating, changing stool consistency such as diarrhea (IBS-D), constipation (IBS-C), or interchanging diarrhea and constipation (mixed-type or IBS-M), mucus secretion, and nausea. 5,6 Community-based data indicate that IBS-M is the most prevalent type followed by IBS-D and IBS-C and that switching among subtypes occurs. Bloating is the most prevalent symptom reported by 96% of patients with IBS of whatever subgroup. 7 In addition to abdominal symptoms, poor sleep, headache, CONTACT Hans Raskov raskov@mail.dk Lundevangsvej 23, DK-2900 Hellerup, Denmark. Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/kgmi.

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Section: Discussionmentioning

confidence: 99%

Irritable bowel syndrome, the microbiota and the gut-brain axis

Raskov¹,

et al. 2016

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“…The GIS has been validated in previous studies [8, 9]. For data analysis, the score was calculated as the sum of factor-analysis based groups of symptoms (factors); at the second step the score was analyzed as multiple endpoints of these factors; and at the third step the factors were analyzed as multiple endpoints of the corresponding symptoms.…”

Section: Methodsmentioning

confidence: 99%

Treatment of Functional Dyspepsia with a Herbal Preparation

Madisch¹,

Holtmann²,

Mayr³

et al. 2004

Digestion

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Background: We aimed to assess the efficacy and safety of a herbal preparation STW 5-II containing extracts from bitter candy tuft, matricaria flower, peppermint leaves, caraway, licorice root and lemon balm for the treatment of patients with functional dyspepsia. Methods: 120 patients with functional dyspepsia were randomly assigned to 1 of 4 treatment groups. Each patient received the treatment for three consecutive 4-week treatment blocks. The first two treatment blocks were fixed. For the third treatment period, medication was based upon the investigator’s judgement of symptom improvement during the preceding treatment period. In patients without adequate control of symptoms, the treatment was switched, or if symptoms were controlled, the treatment was continued. The primary outcome measure was the improvement of a standardized gastrointestinal symptom score (GIS). Findings: During the first 4 weeks, the GIS significantly decreased in subjects on active treatment compared to the placebo (p < 0.001). During the second 4-week period, symptoms further improved in subjects who continued on active treatment or who switched to the active treatment (p < 0.001), while symptoms deteriorated in subjects who switched to placebo. After 8 weeks 43.3% on active treatment and 3.3% on placebo reported complete relief of symptoms. (p < 0.001 vs. placebo). Conclusion: In patients with functional dyspepsia, the herbal preparation tested improved dyspeptic symptoms significantly better than placebo.

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“…Problems with studies evaluating prokinetic agents include small sample size, patient heterogeneity, and poor quality design. Nevertheless, prokinetic agents such as metoclopramide, cisapride, mosapride citrate, itopride hydrochloride and domperidone continue to be widely used for the therapy of functional dyspepsia worldwide [1,2,[27][28][29][30][46][47][48] . Due to its severe cardiac side effects, cisapride is not currently available in most of Europe and North America.…”

Section: Prokinetic Agentsmentioning

confidence: 99%

Drug treatment of functional dyspepsia

Mönkemüller

Malfertheiner

2006

WJG

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the role of Helicobacter pylori (H pylori ) in functional dyspepsia continues to be a matter of debate, recent data indicate that there is modest but clear benefit of eradication of H pylori in patients with functional dyspepsia. In addition, H pylori is a gastric carcinogen and if found it should be eliminated. Although there are no specific diets for patients with FD, it may be helpful to guide the patients on healthy exercise and eating habits.

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A randomized placebo‐controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia

Cited by 83 publications

References 28 publications

Irritable bowel syndrome, the microbiota and the gut-brain axis

Irritable bowel syndrome, the microbiota and the gut-brain axis

Treatment of Functional Dyspepsia with a Herbal Preparation

Drug treatment of functional dyspepsia

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