Functional Dyspepsia

Chang, Chien-Wei; Lin, Yu-Chih; Chen, Chung‐Jen

doi:10.1056/nejmc1515497

Cited by 13 publications

(14 citation statements)

References 15 publications

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“…Use of PPIs is increasingly recognised to be associated with alterations in the gastric, lung, and oropharyngeal Microflora 32 . The importance of this is a source of current debate however, to which we have contributed 40 .…”

Section: Discussionmentioning

confidence: 99%

Microbiological profiles of sputum and gastric juice aspirates in Cystic Fibrosis patients

Al-Momani

Perry

Stewart

et al. 2016

Sci Rep

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Gastro-Oesophageal Reflux (GOR) is a key problem in Cystic Fibrosis (CF), but the relationship between lung and gastric microbiomes is not well understood. We hypothesised that CF gastric and lung microbiomes are related. Gastric and sputum cultures were obtained from fifteen CF patients receiving percutaneous endoscopic gastrostomy feeding. Non-CF gastric juice data was obtained through endoscopy from 14 patients without lung disease. Bacterial and fungal isolates were identified by culture. Molecular bacterial profiling used next generation sequencing (NGS) of the 16S rRNA gene. Cultures grew bacteria and/or fungi in all CF gastric juice and sputa and in 9/14 non-CF gastric juices. Pseudomonas aeruginosa(Pa) was present in CF sputum in 11 patients, 4 had identical Pa strains in the stomach. NGS data from non-CF gastric juice samples were significantly more diverse compared to CF samples. NGS showed CF gastric juice had markedly lower abundance of normal gut bacteria; Bacteroides and Faecalibacterium, but increased Pseudomonas compared with non-CF. Multivariate partial least squares discriminant analysis demonstrated similar bacterial profiles of CF sputum and gastric juice samples, which were distinct from non-CF gastric juice. We provide novel evidence suggesting the existence of an aerodigestive microbiome in CF, which may have clinical relevance.

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Section: Discussionmentioning

confidence: 99%

Microbiological profiles of sputum and gastric juice aspirates in Cystic Fibrosis patients

Al-Momani

Perry

Stewart

et al. 2016

Sci Rep

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“…Moreover, central pain processing may be abnormal in individuals with FD; however, it is unclear whether this is a complication or an early sign of the disease. 2 Given the potential role of the gut-brain axis (GBA) and the abnormal central pain processing in FD, antidepressants have been so far proposed as viable treatments for this condition. Nevertheless, clinical trials regarding the effects of antidepressants in FD have been only conducted over the past decade.…”

Section: Introductionmentioning

confidence: 99%

“…7 These findings suggest that tricyclic antidepressants such as amitriptyline seem to be more effective than selective serotonin reuptake inhibitors or serotonin-norepinephrine drugs in the treatment of FD. 2 Besides, serotonin 5-hydroxytryptamine (5-HT) is a neurotransmitter particularly involved in regulating GI tract motility, smooth muscle tone, mucosal secretion, and neural signaling. Accordingly, 95% of the total body serotonin is secreted by enterochromaffin cells of the digestive system.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Buspirone in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study

Taghvaei

Elyasi

Rahbar

et al. 2021

Middle East J Dig Dis

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BACKGROUND Functional dyspepsia (FD) is a relatively common disorder whose pathogenesis has yet been poorly understood. There are still debates concerning definitions and the best possible treatments for this disorder. We aimed to assess the effectiveness of buspirone, a 5-hydroxytryptamine (HT)1A agonist, in improving the symptoms and quality of life (QoL) as well as psychological dimensions in patients with FD. METHODS This study was a randomized, double-blinded, placebo-controlled trial performed on 30 patients with FD, residing in the city of Sari, northern Iran, from December 2017 to October 2018. Consecutive patients referring to a tertiary hospital with a clinical diagnosis of FD, according to the Rome IV criteria, were recruited. All patients were ethnically Persian and had normal upper endoscopy and negative histological evaluation results for any gastrointestinal disease or helicobacter pylori (H. pylori) infection while evaluating biopsy samples endoscopically. Exclusion criteria were being diagnosed with major psychiatric disorders, suicidal thoughts, recent treatments with psychoactive drugs, as well as major cognitive impairments. Patients were randomly assigned to receive either buspirone (n=18) or placebo (n=12) for two months. The first group received buspirone 5mg three times a day for the first month and 10mg three times a day for the second month. During the treatment course, the patients were advised to report any adverse reactions. Also, both groups were evaluated by three questionnaires [demographic characteristics form, the 36-Item Short-Form Health Survey (SF-36), The Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Hospital Anxiety and Depression Scale(HADS)] at the baseline and at the end of the 8th week by a blinded psychologist. Finally, data were analyzed using SPSS software (version 18). P values <0.05 were considered statistically significant. RESULTS The most common symptoms of the patients were FD followed by heartburn. No significant differences were observed between buspirone and placebo groups regarding QoL (p=0.58), anxiety and depression (p =0.36), and severity and frequency of FD symptoms (p =0.22) before and after the intervention. In both groups, the overall QoL as well as HADS and SF-LDQ scores had significantly improved at the end of the study compared with the baseline. CONCLUSION Our findings indicate no significant effects associated with buspirone on the clinical course of FD, compared with placebo. More studies are needed to introduce effective therapies according to the pathophysiology of FD.

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“…This novel data suggests the existence of an aero-digestive microbiome in CF, which may ultimately have clinical relevance. This host response to aspiration as well as its potential to induce changes in the pulmonary microbiome needs further investigation, with its importance only gradually gaining widespread recognition [ 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Gastric Aspiration and Its Role in Airway Inflammation

Hunt¹,

Sullivan²,

Galvin³

et al. 2018

TORMJ

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Gastro-Oesophageal Reflux (GOR) has been associated with chronic airway diseases while the passage of foreign matter into airways and lungs through aspiration has the potential to initiate a wide spectrum of pulmonary disorders. The clinical syndrome resulting from such aspiration will depend both on the quantity and nature of the aspirate as well as the individual host response. Aspiration of gastric fluids may cause damage to airway epithelium, not only because acidity is toxic to bronchial epithelial cells but also due to the effect of digestive enzymes such as pepsin and bile salts. Experimental models have shown that direct instillation of these factors to airways epithelia cause damage with a consequential inflammatory response. The pathophysiology of these responses is gradually being dissected, with better understanding of acute gastric aspiration injury, a major cause of acute lung injury, providing opportunities for therapeutic intervention and potentially, ultimately, improved understanding of the chronic airway response to aspiration. Ultimately, clarification of the inflammatory pathways which are related to micro-aspiration via pepsin and bile acid salts may eventually progress to pharmacological intervention and surgical studies to assess the clinical benefits of such therapies in driving symptom improvement or reducing disease progression.

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Functional Dyspepsia

Cited by 13 publications

References 15 publications

Microbiological profiles of sputum and gastric juice aspirates in Cystic Fibrosis patients

Microbiological profiles of sputum and gastric juice aspirates in Cystic Fibrosis patients

Effectiveness of Buspirone in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study

Gastric Aspiration and Its Role in Airway Inflammation

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