Gastric emptying and related symptoms in patients treated with buspirone, amitriptyline or clebopride: a "real world" study by 13C-octanoic Acid Breath Test

Caviglia, Gian Paolo; Sguazzini, C; Cisarò, Fabio; Ribaldone, Davide Giuseppe; Rosso, Chiara; Fagoonee, Sharmila; Smedile, Antonina; Saracco, Giorgio Maria; Astegiano, Marco; Pellicano, Rinaldo

doi:10.23736/s0026-4806.17.05320-4

Cited by 18 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Investigative findings associated with increasing FD severity in small studies include shorter time to satiety,251 delayed gastric emptying and increased small bowel contractility on wireless motility capsule,252 longer gastric half emptying time and lag phase on gastric emptying studies,253 254 and altered high resolution electrogastrography spatial patterns 255. Visceral hypersensitivity, adjusted for tendency to report symptoms, is also commoner in both severe EPS and PDS, especially after meals,66 as well as in those with coexistent anxiety and depression 53 68.…”

Section: Treatment Of Fdmentioning

confidence: 99%

“…In terms of uncontrolled studies, in an open-label study of 59 patients refractory to first-line treatment, early satiation and half gastric emptying time improved with the 5-HT 1A agonist buspirone, and postprandial fullness with amitriptyline 254. Acotiamide in combination with a PPI improved otherwise refractory symptoms in an open-label study in 23 patients 277.…”

Section: Treatment Of Fdmentioning

confidence: 99%

See 1 more Smart Citation

British Society of Gastroenterology guidelines on the management of functional dyspepsia

Black

Paine

Agrawal

et al. 2022

Gut

View full text Add to dashboard Cite

Functional dyspepsia (FD) is a common disorder of gut–brain interaction, affecting approximately 7% of individuals in the community, with most patients managed in primary care. The last British Society of Gastroenterology (BSG) guideline for the management of dyspepsia was published in 1996. In the interim, substantial advances have been made in understanding the complex pathophysiology of FD, and there has been a considerable amount of new evidence published concerning its diagnosis and classification, with the advent of the Rome IV criteria, and management. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based diagnosis and treatment of patients. The approach to investigating the patient presenting with dyspepsia is discussed, and efficacy of drugs in FD summarised based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of pairwise and network meta-analyses. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system. These provide both the strength of the recommendations and the overall quality of evidence. Finally, in this guideline, we consider novel treatments that are in development, as well as highlighting areas of unmet need and priorities for future research.

show abstract

Section: Treatment Of Fdmentioning

confidence: 99%

Section: Treatment Of Fdmentioning

confidence: 99%

British Society of Gastroenterology guidelines on the management of functional dyspepsia

Black

Paine

Agrawal

et al. 2022

Gut

View full text Add to dashboard Cite

show abstract

“…A duodenal-release formulation of a combination of caraway oil and L-menthol alongside standard therapy achieved improvements in dyspeptic symptoms among severely affected patients with FD [61]. In uncontrolled studies, a 5-HT1A agonist, buspirone, improved early satiation and gastric emptying, while amitriptyline demonstrated improvement in postprandial fullness among patients who did not respond to first-line therapy [62]. Additional RCTs involving a substantial sample size are necessary to more comprehensively evaluate the efficacy of these approaches.…”

Section: Challenges For Treatment Of Severe and Refractory Symptomsmentioning

confidence: 99%

Functional Dyspepsia: Current Understanding and Future Perspective

Oshima

2023

Digestion

View full text Add to dashboard Cite

Background: Functional dyspepsia (FD) is a common disorder characterized by chronic or recurrent upper abdominal pain or discomfort without any structural abnormalities in the gastrointestinal tract. FD is categorized into two subgroups based on symptoms: postprandial distress syndrome (PDS) and epigastric pain syndrome. Summary: The pathophysiology of FD involves several mechanisms. Delayed gastric emptying is observed in approximately 30% of FD patients but does not correlate with symptom patterns or severity. Impaired gastric accommodation is important in the pathophysiology, particularly for PDS. Visceral hypersensitivity, characterized by heightened sensitivity to normal activities, contributes to the perception of discomfort or pain in FD. Alterations to the duodenal mucosa, including impaired mucosal barrier function and low-grade inflammation, are also implicated in the pathogenesis of FD. Microbial dysbiosis and psychological factors such as stress can further exacerbate symptoms. Treatment options include dietary modifications, establishing a physician-patient relationship, acid suppressants, prokinetics, neuromodulators, and behavioral therapies. Dietary recommendations include eating smaller, more frequent meals, and avoiding trigger foods. Acid suppressants are used as the first-line treatment. Prokinetics and neuromodulators aim to improve gastric motility and central pain processing, respectively. Behavioral therapies, including cognitive behavioral therapy and hypnotherapy, have shown benefits for refractory FD. Severe and refractory cases may require combination therapies or experimental treatments. Key Messages: FD is a disorder of gut-brain interaction involving diverse pathophysiological mechanisms. Individualized treatment based on symptoms and responses to interventions is crucial. Further research is needed to improve the understanding of FD and advance the development of effective therapies.

show abstract

“…Insbesondere für die differenzialdiagnostische Abgrenzung einer funktionellen Dyspepsie von Gastroparese 56 oder für den Nachweis einer signifikant beschleunigten Magenentleerung, die mit früh-postprandialen Symptomen einhergeht, ist die Messung der Magenentleerung richtungsweisend. Neben nuklearmedizinischen Techniken verwendet man oft Atemteste, die auf der Absorption und Messung des stabilen Isotops 13 C in der Atemluft nach Verzehr einer mit 13 C-Octanoat oder 13 C-Octansäure angereicherten festen Testmahlzeit beruhen 57 .…”

Section: Management Von Patienten Mit Dyspeptischen Beschwerdenunclassified