Efficacy of omeprazole in functional dyspepsia: double‐blind, randomized, placebo‐controlled trials (the Bond and Opera studies)

Abstract

Omeprazole is modestly superior to placebo in functional dyspepsia at standard (20 mg) and low doses (10 mg) but not in patients with dysmotility-like dyspepsia.

Pathophysiology and treatment of functional dyspepsia

“…4 Studies have shown correlations between this subdivision and the presence of Helicobacter pylori infection or delayed gastric emptying, 16 and between this subdivision and response to acid-suppressive therapy. 17 However, the subdivision has also been criticized because of the significant overlap between the symptom subgroupings, the considerable number of patients who do not fit into one of the subgroups, and the lack of adequate value in predicting underlying organic disease. 2,18 Dyspeptic symptoms are often aggravated by food ingestion.…”

“…In functional dyspepsia, the efficacy of H 2 receptor antagonists is equivocal, but proton pump inhibitors are found to be beneficial. 61,62 Although a subset of functional dyspepsia patients responds to acid-suppressive therapy, this positive response is confined to patients with ulcer-like and reflux-like dyspepsia. Those with dysmotility-like symptoms do not respond better to acid suppression than to placebo.…”

“…Those with dysmotility-like symptoms do not respond better to acid suppression than to placebo. 61 We recently studied a large group of functional dyspepsia patients without dominant symptoms of heartburn and found pathologic esophageal acid exposure in 17% of them. These patients were characterized by a higher prevalence of postprandial pain.…”

Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six‐week placebo‐controlled, double‐blind, multicentre trial

“…3 Pharmacological treatment for patients with functional dyspepsia remains unsatisfactory. 4 Some controlled trials have demonstrated that H 2 -receptor antagonists 5 and proton-pump inhibitors 6 are better than a placebo, but the benefits have been modest. Several randomized controlled trials (RCTs) have demonstrated the superiority of cisapride over a placebo, but although this has been confirmed in systematic reviews and meta-analyses [7][8][9] its use is now restricted in most countries because of rare cardiac side-effects.…”

Efficacy of Acotiamide in Combination with Esomeprazole for Functional Dyspepsia Refractory to Proton-Pump Inhibitor Monotherapy

“…Although a standard treatment for FD has not been established, PPIs are widely used as the initial treatment choice in patients with EPS dominant FD. Several randomized controlled studies suggested that the efficacy of PPI therapy for FD is limited, and it may be confined to those patients who have co-existing EPS (Talley et al 1998;Blum et al 2000;Bolling-Sternevald et al 2002;Wong et al 2002;Peura et al 2004). One randomized control study compared PPI therapy to a placebo in FD patients with ulcer-like symptoms (van Rensburg et al 2008).…”