ABSTRACT
Background: Functional dyspepsia (FD) accounts for majority of dyspepsia. Before labeling them as FD, a bunch of investigations to be done to rule out organic cause. Small intestinal bacterial overgrowth (SIBO) which is one of the cause for dyspepsia is not commonly sought and always neglected among physicians. So we aimed to study the frequency of SIBO in patients with dyspeptic symptoms and whether to include investigations to diagnose SIBO in the algorithm of approach to dyspepsia. Materials and methods: We consecutively enrolled 50 newly diagnosed functional dyspepsia patients based on Rome III criteria and 50 healthy controls in this study. They underwent glucose hydrogen breath test (GHBT) after overnight fasting. Results: In the cases with FD, 6 (12%) subjects were found to have positive GHBT and diagnosed as SIBO, whereas in the controls 2 (4%) had positive GHBT with no statistical significant difference among groups with a P value of 0.140. In the cases with FD, the most common subtype was post prandial distress syndrome (46%), followed by epigastric pain syndrome (36%) and mixed type Sabarinathan Ramanathan, Premkumar Karunakaran, Kani Shaikh Mohamed, Ratnakar Kini, Pugazhendhi Thangavel, Murali Ananthavadivelu, Mohammed Ali, Rabindranath Eswaran, Thinakar Mani, Chandrashekar Patil. A study on the role of small intestinal bacterial overgrowth in patients with functional dyspepsia. IAIM, 2017; 4(5): 88-97. Page 89 (18%). Patients with SIBO were treated with rifaximin 1200 mg/day in divided doses for 10 days. GHBT was repeated after 4 weeks and found to be normalized in all cases. Conclusion: SIBO should be considered before making a diagnosis of FD. GHBT is a simple noninvasive method to diagnose SIBO. One could avoid taking unnecessary drugs by timely diagnosis of SIBO in patients with dyspepsia.
ABSTRACT
The present study was aimed to assess the combined effects of cyclooxygenase and 5-lipoxygenase (COX/5-LOX) inhibitors in different animal models of nociception. Naproxen, nimesulide and rofecoxib are well-established antinociceptive agents acting via COX inhibition. AKBA (acetyl-keto-beta-boswellic acid) is a 5-LOX inhibitor. AKBA (50-200 mg/kg) produced a dose dependent and significant antinociceptive effect in different animal models of nociception. Based on the earlier reports from our laboratory, sub effective doses of all the three COX Inhibitors were selected and they were administered (naproxen, 5 mg/kg; nimesulide, 1 mg/kg; and rofecoxib, 1 mg/kg) with AKBA (100 mg/kg). This produced a more significant antinociceptive effect as compared to per se effect observed in all the three models of nociception. However, the effect of combination of nimesulide with AKBA was more pronounced as compared to naproxen and rofecoxib and their combination with AKBA. The present finding provided an evidence for the potentiation of antinociceptive effect of NSAIDs with AKBA. Such a combination may help to reduce the therapeutic doses of conventional NSAIDs and also reduce side effects (gastric, cardiac and renal) that are popularly associated with the NSAIDs.