Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia

Tan, Victoria P.; Liu, K. S. H.; Lam, Frank Y.F.; Hung, Ivan Fan-Ngai; Yuen, Man‐Fung; Leung, Wai K.

doi:10.1111/apt.13945

Cited by 120 publications

(101 citation statements)

References 27 publications

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“…New treatment options are emerging based on these concepts, including anti-inflammatory drugs (at least in paediatric functional dyspepsia, montelukast (a cysteinyl leukotriene receptor 1 antagonist) has yielded promising results) 233 and non-absorbable antibiotics, such as rifaximin 234 . New data support the role of low-dose tricyclic antidepressants in functional dyspepsia, although the mechanism of action is unclear 200 .…”

Section: Discussionmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

261

247

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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: Discussionmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

261

247

View full text Add to dashboard Cite

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“…22 Other triggers have been on relapse and retreatment are not available. 30 While rifaximin's predominant effect in functional dyspepsia is believed to be antibiotic, its anti-inflammatory properties may contribute to symptom relief. 30 …”

Section: Dietmentioning

confidence: 99%

Functional dyspepsia

Talley¹,

Goodsall²,

Potter³

2017

Aust Prescr

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“…These findings are supported by the recent publication of a placebo-controlled trial in which treatment with the poorly absorbed antibiotic rifaximin was found to reduce symptoms in FD patients 33 .…”

Section: General Considerationsmentioning

confidence: 61%

Life in the small intestine: the forgotten microbiome?

2017

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The gastrointestinal (GI) microbiota is now widely accepted to be an important modulator of our health and well-being. The microbes colonising the GI tract aid in promoting gut and immune homeostasis, while alterations in the composition and/or density of these microbes, often referred to as dysbiosis, have been implicated in many intestinal and extra-intestinal disorders. As a result, the GI microbiota is of increasing interest as a therapeutic target. This is particularly the case in the context of GI disorders linked to chronic inflammation of the mucosa. In this article, we focus on the small intestinal microbiota, which in many senses can be considered the ‘forgotten' gut microbiome.

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Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia

Abstract: Treatment with 2 weeks of rifaximin led to adequate relief of global dyspeptic symptoms, belching and post-prandial fullness/bloating in subjects with functional dyspepsia. The difference was more marked in females. (clinicaltrials.org NCT01643083).

Cited by 120 publications

References 27 publications

Functional dyspepsia

Functional dyspepsia

Functional dyspepsia

Life in the small intestine: the forgotten microbiome?

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