Randomised clinical trial: sustained response to PPI treatment of symptoms resembling functional dyspepsia and irritable bowel syndrome in patients suffering from an overlap with erosive gastro‐oesophageal reflux disease

Mönnikes, Hubert; Schwan, Thomas J.; Rensburg, Christo van; Straszak, Andrzej; Theek, Carmen; Sander, Peter; Lühmann, R

doi:10.1111/j.1365-2036.2012.05085.x

Cited by 31 publications

(31 citation statements)

References 45 publications

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“…Cessation of PPI treatment induced a recurrence of the reflux symptoms, but relief of FD or IBS symptoms was maintained after cessation of PPIs. 81 Although a detailed mechanism of these effects of PPIs is unknown, they might be due to a placebo effect for symptoms of FD and IBS, or recurrence of FD or IBS symptoms may take longer than those of reflux. One small, randomized controlled trial with tegaserod (a 5-hydroxytryptamine 4 agonist) was reported, where 25 patients with overlapping functional heartburn and FD (Rome II) were randomized to receive tegaserod or a placebo.…”

Section: Treatment For Overlaps In Patients W Ith Dyspepsia/functionamentioning

confidence: 99%

Overlap in Patients With Dyspepsia/Functional Dyspepsia

Fujiwara¹

2014

J Neurogastroenterol Motil

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Patients with dyspepsia/functional dyspepsia (FD) show frequent overlapping of other gastrointestinal (GI) diseases, such as irritable bowel syndrome, and non-GI diseases, in addition to internal subgroup overlapping. These overlap patients have more frequent or more severe symptoms, poorer health-related quality of life and higher somatization scores, and they are more likely to experience anxiety, depression or insomnia compared to non-overlap patients. The higher prevalence of overlap in patients with dyspepsia/FD is not by chance, indicating common pathogeneses, including visceral hypersensitivity, altered GI motility, infection, and stressful early life events. There are few clinical trials targeting overlap in patients with dyspepsia/FD, and no therapeutic strategy has been established. Further studies in this research area are needed. In this review, we describe the epidemiology, pathogenesis and treatment of overlap in patients with dyspepsia/FD.

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Section: Treatment For Overlaps In Patients W Ith Dyspepsia/functionamentioning

confidence: 99%

Overlap in Patients With Dyspepsia/Functional Dyspepsia

Fujiwara¹

2014

J Neurogastroenterol Motil

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“…The design and primary results of this prospective clinical trial (ClinicalTrials.gov identifier: NCT00325676) have been previously described elsewhere [18]. This report includes prospectively defined subgroup analyses of therapy-associated changes of GI symptomatology and HRQoL.…”

Section: Methodsmentioning

confidence: 99%

“…This report includes prospectively defined subgroup analyses of therapy-associated changes of GI symptomatology and HRQoL. In brief, this randomized, multicenter, multinational, parallel group study (June 2006 to May 2007) was conducted in patients with GERD diagnosed endoscopically according to the Los Angeles classification (LA grade A–D) (full inclusion and exclusion criteria have been previously presented [18]). To assess the treatment effects based on duration and intensity of PPI administration, patients were randomized to two different treatment concepts: classical healing (CH) and complete remission (CR) (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Possible etiology of improvements in both quality of life and overlapping gastroesophageal reflux disease by proton pump inhibitor treatment in a prospective randomized controlled trial

et al. 2013

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BackgroundSymptoms suggestive of functional dyspepsia (FD) and irritable bowel syndrome (IBS) frequently overlap with those of gastroesophageal reflux disease. Despite the high prevalence of symptomatic overlap, the underlying etiology remains poorly defined. We assessed the correlation of symptomatic relief and health-related quality of life (HRQoL) with healing of reflux esophagitis to further derive insights into the underlying etiology.Methods626 patients with reflux esophagitis were enrolled into one of two treatment groups (classical healing concept or the complete remission concept) to investigate differences in treatment intensity. Patients were treated with pantoprazole until esophageal mucosal healing. Remission was followed for up to 6 months without treatment. Gastro-intestinal symptoms and HRQoL were analyzed using disease-specific, psychometrically validated patient-reported outcome instruments (ReQuest™, GERDyzer™).ResultsSymptomatic burden reflected by ReQuest™ substantially decreased from baseline to end of treatment by 83% and 88% in either treatment group, respectively. ReQuest™ scores significantly decreased in patients with or without heartburn and in those with symptoms suggestive of FD and IBS, indicating response of all symptom categories to treatment (p < 0.005). Therapy-associated relief of symptoms was paralleled by substantial gains in HRQoL, which continued to stabilize post-treatment.ConclusionsPantoprazole is effective in relieving upper and lower gastro-intestinal symptoms overlapping with erosive esophagitis, and provides sustained improvement in HRQoL post-treatment. Our results propose a link between both healing of erosive esophagitis and the slower remission of upper and lower gastro-intestinal symptoms. Since the improvement observed is likely to be multifactorial, the possibility for an immune-mediated etiology and identification of putative susceptibility factors by genome-wide association study may provide focus for future research.Trial registrationClinicalTrials.gov identifier: NCT00325676.

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“…Insgesamt gibt es in Deutschland und international vielfältige Forschungsaktivitäten zur Therapie. Beispielhaft seien an dieser Stelle aktuelle Arbeiten aus Hamburg [13], Berlin [41], Tübingen [9,39] und Heidelberg/Saarbrücken [49] genannt.…”

Section: Therapie Und Krankenversorgung Am Standort Deutschlandunclassified

Viszeraler Schmerz

Elsenbruch

Haüser

Jänig

2015

Schmerz

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Chronic visceral pain is an unresolved neurobiological, medical and socioeconomic challenge. Up to 20% of the adult population suffer from chronic visceral pain and abdominal complaints constitute a prevalent symptom also in children and adolescents. Existing treatment approaches are often unsuccessful and patients typically suffer from multiple somatic and psychological symptoms. This complex situation requires integrative treatment approaches. This review summarizes current basic and clinical research on acute and chronic visceral pain with a focus on research groups in Germany. Despite significant clinical and scientific advances, a number of questions remain open calling for more funding to support research to elucidate the complex pathophysiology of chronic visceral pain and to develop and test new treatment approaches. Research support should focus on interdisciplinary concepts and methodology using expertise from multiple disciplines. The field would also benefit from a broader integration of visceral pain into teaching curricula in medicine and psychology and should aim to motivate young clinicians and scientists to strive for a career within this important and highly fascinating area.

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Randomised clinical trial: sustained response to PPI treatment of symptoms resembling functional dyspepsia and irritable bowel syndrome in patients suffering from an overlap with erosive gastro‐oesophageal reflux disease

Cited by 31 publications

References 45 publications

Overlap in Patients With Dyspepsia/Functional Dyspepsia

Overlap in Patients With Dyspepsia/Functional Dyspepsia

Possible etiology of improvements in both quality of life and overlapping gastroesophageal reflux disease by proton pump inhibitor treatment in a prospective randomized controlled trial

Viszeraler Schmerz

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