Emerging drugs for functional dyspepsia

Zala, Alkesh; Walker, Marjorie M.; Talley, Nicholas J.

doi:10.1517/14728214.2015.1009827

Cited by 37 publications

(39 citation statements)

References 111 publications

(69 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The majority of patients do not respond to this therapy, and it is most useful in those with epigastric pain. 24 An alternative is H 2 receptor antagonist therapy, which is also superior to placebo. Some patients find this helpful even if proton pump inhibitors have failed.…”

Section: Acid Suppressionmentioning

confidence: 99%

Functional dyspepsia

Talley¹,

Goodsall²,

Potter³

2017

Aust Prescr

Self Cite

View full text Add to dashboard Cite

Section: Acid Suppressionmentioning

confidence: 99%

Functional dyspepsia

Talley¹,

Goodsall²,

Potter³

2017

Aust Prescr

Self Cite

View full text Add to dashboard Cite

“…In small trials there is a greater improvement of symptoms in patients treated with cognitive psychotherapy than in a control group that received no specific treatment, and in FD patients with refractory symptoms, CBT was effective for the control of concomitant anxiety and depression, but more studies are needed in this area [14]. For the management of FD, there is now reasonably convincing evidence that SSRIs and selective serotonin norepinephrine reuptake inhibitors are not efficacious [58,59]. In addition, SSRIs can cause dyspepsia, and are associated with an increased risk of upper gastrointestinal tract bleeding [60].…”

Section: Stress and The Brain-gut Axismentioning

confidence: 99%

“…Importantly, negative results in limited trials do not exclude a positive result with other antidepressants, and further studies are awaited [58].…”

Section: Stress and The Brain-gut Axismentioning

confidence: 99%

See 1 more Smart Citation

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

View full text Add to dashboard Cite

Functional gastrointestinal disorders (FGIDs) are common and distressing. They are so named because a defined pathophysiology in terms of structural or biochemical pathways is lacking. Traditionally FGIDs have been conceptualized as brain-gut disorders, with subgroups of patients demonstrating visceral hypersensitivity and motility abnormalities as well as psychological distress. However, it is becoming apparent that there are certain structural or biochemical gut alterations among subsets with the common FGIDs, most notably functional dyspepsia (FD) and irritable bowel syndrome (IBS). For example, a sodium channel mutation has been identified in IBS that may account for 2 % of cases, and subtle intestinal inflammation has been observed in both IBS and FD. Other research has implicated early life events and stress, autoimmune disorders and atopy and infections, the gut microbiome and disordered mucosal immune activation in patients with IBS or FD. Understanding the origin of symptoms in FGIDs will allow therapy to be targeted at the pathophysiological changes, not at merely alleviating symptoms, and holds hope for eventual cure in some cases.For example, there are promising developments in manipulating the microbiome through diet, prebiotics and antibiotics in IBS, and testing and treating patients for Helicobacter pylori infection remains a mainstay of therapy in patients with dyspepsia and this infection. Locally acting drugs such as linaclotide have been an advance in treating the symptoms of constipation-predominant IBS, but do not alter the natural history of the disease. A role for a holistic approach to patients with FGIDs is warranted, as brain-togut and gut-to-brain pathways appear to be activated.

show abstract

“…It is unclear whether FAERS reports associated with treatment of dyspepsia refer to the syndrome of functional dyspepsia or with isolated dyspepsia, a symptom commonly accompanying gastroesophageal reflux disease [1,3]. This distinction remains important globally since treatment of functional dyspepsia can include the use of the few prokinetic agents available for functional dyspepsia, including, metoclopramide, a drug that is not generally recommended [12]. Reports in which gastroparesis was the treatment indication included concurrent hypoglycemic agents in 29% [11] consistent with the predicted prevalence of diabetes mellitus [8].…”

mentioning

confidence: 99%