A survey of pharmacological and nonpharmacological treatment of functional gastrointestinal disorders

Abstract

Background: Treatment of functional gastrointestinal disorders (FGIDs) is based on symptoms relieve by conventional drugs, but increasingly complementary and alternative medicine (CAM) is used. Objective: This survey aimed to investigate the current treatments used by FGIDs patients. Methods: A total of 25 Italian gastroenterologists interviewed outpatients on gastrointestinal symptoms and treatments (pharmacological, CAM, diet/dietary supplements) used during the last year to relieve FGIDs. Consecutive adults with FGIDs according to Rome III were included. Results: Of the 199 patients, 81% used conventional drugs, 64.3% diet/dietary supplements, and 48.7% CAM. Conventional drugs, diet/dietary supplements, or CAM as exclusive treatment were used by 24.6, 6, and 2.5% of patients, respectively. Two-thirds used more than one treatment: 34.7% conventional drugs, CAM, and diet/dietary supplements, 17.1% conventional drugs and diet/dietary supplements, 10.1% diet and CAM, and 5% conventional drugs and CAM. Benefits and adverse effects were similar for conventional drugs and nonpharmacological treatments. Males (OR 2.4) without lower GI symptoms (OR 5.4) used more frequently exclusive pharmacological treatment of FGIDs. Conclusions: Conventional drugs are the preferred treatment for FGID. CAM and dietary modifications are more likely used as an adjunct to rather than instead of conventional drugs. Adverse effects occurred in all treatments.

Functional Dyspepsia

“…Given the limited efficacy of the majority of conventional medical therapies, it is not surprising that up to 50% of patients with functional dyspepsia seek out other forms of treatment 71 ; in one study, nearly 50% of the patients were willing to accept a 12.7% risk of sudden death with a drug that offered a 99% chance of cure, 72 in the hope of improving their symptoms and quality of life. However, consistent evidence of the efficacy of acupuncture, homeopathy, or probiotics in functional dyspepsia is lacking.…”

Emerging drugs for functional dyspepsia

“…Owing to lack of established treatment regimens and an unclear pathophysiology, alternative medications are increasingly used in FD [104]. These include acupuncture, herbal remedies and aromatherapy.…”

Free fecal water in the horse – an unsolved problem

“…Zusammenhänge mit der Ernährung konnten beim Menschen bisher nicht belegt werden. Studien im Rahmen eines Fragebogens die sich mit einer diätetischen Behandlung auseinandersetzten, konnten keine signifikante Verbesserung aufzeigen (Lahner et al 2013). Einige wissenschaftliche Studien aus der Humanmedizin sehen einen Zusammenhang der FGID mit chronischen unterschwelligen Entzündungen des Darms (Kindt et al 2009, Dunlop et al 2006, Masaoka et al 2014 Reduktion der Aufnahme von Sorbitol und Coffein, wobei der Erfolg der unterschiedlichen Therapien kontrovers geschildert wird (Palmer et al 1980, Olesen et al 2000, Cremonini et al 2003, Banaszkiewicz and Szajewskaet 2005, Dear et al 2005, Lim et al 2006, Longstreth et al 2006, Bu et al 2007, Flik et al 2011, Paineau et al 2008, Tabbers et al 2009, Guerra et al2011, Mannheim et al 2012 …”