Functional dyspepsia. Different mechanisms, comprehensive treatment
Keywords:functional dyspepsia, proton pump inhibitors, prokinetics
Functional dyspepsia (FD) is a disease with different prevailing pathogenetic mechanisms. The prevalence of FD varies widely from 10 to 30 % of the population, depending on the country and the surveyed cohort. There are two forms of FD: postprandial distress syndrome manifested by a fullness/early satiety after eating, and epigastric pain syndrome — pain/burning in the epigastrium, which may worsen after eating. In a significant part of patients with FD, there are manifestations of both syndromes, the so-called overlap, or a mixed type. In the Ukrainian population, all patients with dyspepsia should be diagnosed and, if found, — undergo mandatory eradication of H.pylori. In patients with persistent symptoms or in those initially not infected with H.pylori, in our opinion, it is advisable to use the combination of proton pomp inhibitor and prokinetic as starting treatment. In our country, a fixed combination of omeprazole and domperidone is available in two dosages. This is Omez D containing 10 mg of both components and a more highly dosed Omez DSR containing 20 mg of omeprazole and 30 mg of domperidone in the form of sustained-release pellets.
Dorofeev AE, Agibalov AN, Rudenko NN, et al. Functional dyspepsia and Helicobacter pylori infection: practical aspects of patient management. Zdorov’ja Ukrai'ny. Gastroenterologiia. 2014;3:19-20. (in Russian).
Bolling-Sternevald E, Lauritsen K, Aalykke C, et al. Effect of profound acid suppression in functional dyspepsia: a double-blind, randomized, placebo-controlled trial. Scand J Gastroenterol. 2002 Dec;37(12):1395-402. PMID: 12523588.
Chen SL, Ji JR, Xu P, et al. Effect of domperidone therapy on nocturnal dyspeptic symptoms of functional dyspepsia patients. World J Gastroenterol. 2010 Feb 7;16(5): 613-7. doi: 10.3748/wjg.v16.i5.613.
Dehghani SM, Imanieh MH, Oboodi R, Haghighat M. The comparative study of the effectiveness of cimetidine, ranitidine, famotidine, and omeprazole in treatment of children with dyspepsia. ISRN Pediatr. 2011;2011:219287. doi: 10.5402/2011/219287.
Ehrenpreis ED, Roginsky G, Alexoff A, Smith DG. Domperidone is Commonly Prescribed With QT-Interacting Drugs: Review of a Community-based Practice and a Postmarketing Adverse Drug Event Reporting Database. J Clin Gastroenterol. 2017 Jan;51(1):56-62. doi: 10.1097/MCG.0000000000000543.
Freedberg DE, Kim LS, Yang YX. The Risks and Benefits of Long-term Use of Proton Pump Inhibitors: Expert Review and Best Practice Advice From the American Gastroenterological Association. Gastroenterology. 2017 Mar;152(4):706-15. doi: 10.1053/j.gastro.2017.01.031.
Hojo M, Nagahara A, Asaoka D, et al. A Randomized, Double-Blind, Pilot Study of the Effect of Famotidine on Acotiamide Treatment for Functional Dyspepsia. Digestion. 2017;96(1):5-12. doi: 10.1159/000477345.
Xiang Z, Ma H, Mou Y, Xu CF. Association between polymorphism of dopamine D2 receptor genes and therapeutic effect of domperidone in functional dyspepsia. Turk J Gastroenterol. 2015 Jan;26(1):1-5. doi: 10.5152/tjg.2015.5122.
Zhang CL, Geng CH, Yang ZW, et al. Changes in patients' symptoms and gastric emptying after Helicobacter pylori treatment. World J Gastroenterol. 2016 May 14; 22(18): 4585-93. doi: 10.3748/wjg.v22.i18.4585.
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