Effect of selective CCK<sub>1</sub> receptor antagonism on accommodation and tolerance of intestinal gas in functional gut disorders

Lobo, Beatriz; Serra, Jordi; D’Amato, Massimo; Rovati, Lucio C.; Malagelada, Juan–R.; Santos, Javier; Azpiroz, Fernando

doi:10.1111/jgh.13177

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…An experimental gas challenge test (high-rate exogenous gas infusion directly into the jejunum) has shown that patients with functional dyspepsia who complain of bloating have impaired handling of intestinal gas, that is, gas retention, abdominal symptoms or both 165 . However, studies using abdominal CT and MRI scanning in clinical conditions could not corre late abdominal symptoms with excessive intestinal gas in these patients, as in the majority of the patients the volume and distribution of intestinal gas were within the normal ranges 166,167 .…”

Section: Gas-related Symptomsmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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Section: Gas-related Symptomsmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

Self Cite

253

247

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“…To overcome these problems, our study applied very precise selection criteria through a comprehensive preentry selection process and measured symptoms during standard conditions and in response to a challenge test. Previous studies using the gas challenge test showed that patients with functional gut symptoms have impaired transit and poor tolerance to intestinal gas loads 6–9…”

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confidence: 99%

Effect of Chicory-derived Inulin on Abdominal Sensations and Bowel Motor Function

Azpiroz

Molne

Mendez

et al. 2017

Journal of Clinical Gastroenterology

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Goal:To determine the effect of a prebiotic chicory-derived inulin-type fructan on the tolerance of intestinal gas.Background:Subjects with gas-related complaints exhibit impaired handling of intestinal gas loads and we hypothesized that inulin would have a beneficial effect.Study:Placebo-controlled, parallel, randomized, double-blind trial. Subjects with abdominal symptoms and reduced tolerance of intestinal gas (selected by a pretest) received either inulin (8 g/d, n=18) or maltodextrin as a placebo (8 g/d, n=18) for 4 weeks. A gas challenge test (4 h jejunal gas infusion at 12 mL/min while measuring abdominal symptoms and gas retention for 3 h) was performed before and at the end of the intervention phase. Gastrointestinal symptoms and bowel habits (using daily questionnaires for 1 wk) and fecal bifidobacteria counts were measured before and at the end of the intervention.Results:Inulin decreased gas retention during the gas challenge test (by 22%; P=0.035 vs. baseline), while the placebo did not, but the intergroup difference was not statistically significant (P=0.343). Inulin and placebo reduced the perception of abdominal sensations in the gas challenge test to a similar extent (by 52% and 43%, respectively). Participants reported moderate gastrointestinal symptoms and normal bowel habits during baseline examination, and these findings remained unchanged in both groups during the intervention. Inulin led to a higher relative abundance of bifidobacteria counts (P=0.01 vs. placebo).Conclusions:A daily dose of inulin that promotes bifidobacteria growth and may improve gut function, is well tolerated by subjects with gastrointestinal complaints.

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“…This outcome concurs with the results of a previous study evaluating the effect of Dexloxiglumide on intestinal gas transit. As observed with prucalopride, Dexloxiglumide, a CCK1 antagonist with prokinetic effects, did not reduce gas retention during the gas challenge test …”

Section: Discussionmentioning

confidence: 50%

“…Previous studies showed that these scales detect significant and consistent differences between different groups of subjects (patients and healthy subjects) in different experimental conditions (i.e. intestinal fat infusion, gastric distension, exercise, and drugs) …”

Section: Methodsmentioning

confidence: 98%

Effect of prucalopride on intestinal gas tolerance in patients with functional bowel disorders and constipation

Malagelada

Coira

Mendez

et al. 2017

J of Gastro and Hepatol

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Effect of selective CCK₁ receptor antagonism on accommodation and tolerance of intestinal gas in functional gut disorders

Abstract: Inhibition of CCK1 receptors by dexloxiglumide increases intestinal gas retention and reduces abdominal symptoms in response to by intestinal gas loads. European Clinical Trials Database (EudraCT 2005-003338-16).

Cited by 7 publications

References 30 publications

Functional dyspepsia

Functional dyspepsia

Effect of Chicory-derived Inulin on Abdominal Sensations and Bowel Motor Function

Effect of prucalopride on intestinal gas tolerance in patients with functional bowel disorders and constipation

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Effect of selective CCK1 receptor antagonism on accommodation and tolerance of intestinal gas in functional gut disorders

Abstract: Inhibition of CCK1 receptors by dexloxiglumide increases intestinal gas retention and reduces abdominal symptoms in response to by intestinal gas loads. European Clinical Trials Database (EudraCT 2005-003338-16).

Cited by 7 publications

References 30 publications

Functional dyspepsia

Functional dyspepsia

Effect of Chicory-derived Inulin on Abdominal Sensations and Bowel Motor Function

Effect of prucalopride on intestinal gas tolerance in patients with functional bowel disorders and constipation

Contact Info

Product

Resources

About

Effect of selective CCK₁ receptor antagonism on accommodation and tolerance of intestinal gas in functional gut disorders