Prevalencia de dispepsia funcional en adolescentes cubanos / Prevalence of Functional Dyspepsia in Cuban Adolescents

Resumen Introducción: los trastornos digestivos funcionales son frecuentes en niños; sin embargo, hay escasos datos sobre la dispepsia funcional (DF) en adolescentes cubanos. Objetivo: determinar la prevalencia de DF en adolescentes cubanos y sus posibles asociaciones. Metodología: se usó el cuestionario para síntomas digestivos pediátricos de Roma IV en español para identificar la presencia de DF en adolescentes de 3 centros escolares de La Habana, Cuba. Se tuvieron en cuenta variables sociodemográficas, personales, familiares, clínicas y epidemiológicas. Resultados: de los 318 adolescentes que participaron en el estudio, 11 adolescentes (3,5 %) de 11,4 ± 1,2 años de edad, 81,8 % de sexo femenino, presentaron DF. La DF fue más frecuente en el sexo femenino (odds ratio [OR]: 5,33; intervalo de confianza [IC] 95 %: 1,06-51,45; p = 0,019). El síndrome de dificultad posprandial (SDP) fue mayor que el síndrome de dolor epigástrico (SDE) en una proporción 1,8:1. En el 63,6 % se presentó superposición entre DF y estreñimiento funcional. Hubo predominio de DF en los niños con padres separados/divorciados (OR: 4,74; IC 95 %: 1,09-28,31; p = 0,014). Conclusión: la DF es más común en adolescentes femeninas, el SDP es el subtipo más frecuente y su presencia está asociada con padres separados/divorciados.

Abstract Introduction: functional gastrointestinal disorders (FGID) are common in children. However, data on functional dyspepsia (FD) in Cuban adolescents is scarce. Objective: to determine the prevalence of FD in Cuban adolescents and their possible associations. Methodology: the questionnaire for pediatric digestive symptoms of Rome IV was used in Spanish to identify the presence of DF in adolescents from 3 schools in La Havana, Cuba. Sociodemographic, personal, family, clinical, and epidemiological variables were considered. Results: of the 318 adolescents who participated in the study, 11 (3.5%) aged 11.4 ± 1.2 years, 81.8% female, presented FD. Functional dyspepsia was more frequent in females (odds ratio [OR]: 5.33; 95% confidence interval [CI]: 1.06-51.45; p = 0.019). The postprandial distress syndrome (PDS) was higher than the epigastric pain syndrome (SDE) by a 1.8:1 ratio. There was an overlap between DF and functional constipation in 63.6% of the patients. There was an FD predominance in children with separated or divorced parents (OR: 4.74; 95% CI: 1.09-28.31; p = 0.014). Conclusion: functional dyspepsia is most common in female adolescents, PSD is the most frequent subtype, and its presence is associated with separated or divorced parents.

Improvement in dyspepsia related symptoms treated with acupuncture in 278 patients with postprandial distress syndrome: a secondary analysis of a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To evaluate the clinical effect of acupuncture for the improvements in various dyspeptic symptoms of postprandial distress syndrome.@*METHODS@#The secondary analysis on the data of a multi-center randomized controlled trial (RCT) was conducted. 278 patients with postprandial distress syndrome were randomized into an acupuncture group (138 cases) and a sham-acupuncture group (140 cases). In the acupuncture group, acupuncture was applied to Baihui (GV 20), Danzhong (CV 17), Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6), Zusanli (ST 36), etc. In the sham-acupuncture group, 6 sites, neither located on meridians nor belonged to meridian acupoints, were selected and punctured shallowly. The duration of treatment was 20 min each time, 3 times a week, for 4 weeks totally in the two groups. The follow-up visit lasted for 12 weeks. The scores of dyspeptic symptoms were compared between the two groups before treatment, during treatment (in week 1, 2, 3 and 4) and during follow-up (in week 8, 12 and 16) separately.@*RESULTS@#Besides the scores of early satiety and vomiting in the sham-acupuncture group in week 1, the scores of the other dyspepsia symptoms during treatment and follow-up were all reduced in the two groups as compared with those before treatment (@*CONCLUSION@#Acupuncture remarkably relieves postprandial fullness, early satiety, upper abdominal bloating and belching in patients with postprandial distress syndrome.

Optimization and implementation of clinical trial of acupuncture: reflection on the successful case of acupuncture for postprandial distress syndrome / 中国针灸

Taking the clinical trial of acupuncture in treatment of postprandial distress syndrome as an example, this paper proposes that the acupuncture clinical trial protocol should be optimized in view of acupuncture prescription, acupuncture frequency and outcomes. Besides, the data quality of acupuncture clinical trial should be improved in consideration of data sharing and electronic data capture so as to provide a reference for the majority of researchers to optimize and implement acupuncture clinical trial.

Efficacy and safety of the combination of agomelatine and low-dose olanzapine in 184 cases of postprandial distress syndrome with depression, anxiety and sleep disorders / 中华消化杂志

Objective:To observe the efficacy and safety of the combination of agomelatine and low-dose olanzapine (AO) in the treatment of postprandial distress syndrome (PDS) with depression, anxiety and sleep disorders.Methods:From April 2019 to September 2020, PDS patients with depression, anxiety and sleep disorders in Tianjin Medical University General Hospital were selected and divided into AO group and flupentixol-melitracen (FM) group. Patients of the AO group were given oral agomelatine 25 mg and AO 1.70 mg (both once per day), and the patients of FM group were given oral FM 10.5 mg (once per day), and all patients took itopride 50 mg (three times per day) at the same time. The total treatment course was eight weeks. Nepean dyspepsia index-symptom (NDIS), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Pittsburgh sleep quality index (PSQI) were used to evaluate the gastrointestinal symptoms, depression, anxiety and sleep disorders before treatment and two, four and eight weeks after treatment, respectively. The efficacy was evaluated according to the changes of scores of gastrointestinal symptoms before and after treatment. The adverse effects after medication were recorded. Independent sample t test and chi-square test were used for statistical analysis. Results:A total of 184 PDS patients with depression, anxiety and sleep disorders were enrolled, including 98 patients in AO group and 86 patients in FM group. At two, four and eight weeks after treatment, NDIS, PHQ-9, GAD-7 and PSQI scores of AO group and FM group were all lower than those of each group before treatment (AO group: 13.73±0.53, 10.13±0.44 and 7.87±0.31 vs. 27.08±0.84; 6.04±0.35, 4.70±0.31 and 3.81±0.22 vs. 10.04±0.50; 6.36±0.30, 5.29±0.28 and 4.21±0.19 vs. 10.71±0.51; 6.64±0.37, 5.27±0.35 and 4.09±0.30 vs. 11.14±0.42; FM group: 15.33±0.58, 11.58±0.50 and 9.80±0.35 vs. 25.10±0.79; 6.79±0.35, 5.71±0.32 and 4.86±0.30 vs. 9.11±0.46; 7.27±0.31, 6.51±0.32 and 5.21±0.27 vs. 9.79±0.44; 8.01±0.33, 6.76±0.32 and 5.78±0.32 vs. 10.44±0.32), and the differences were statistically significant (AO group: tNDIS=13.470, 17.930 and 21.530, tPHQ-9=6.488, 8.991 and 11.300, tGAD-7=7.361, 9.315 and 11.031, tPSQI=7.088, 9.736 and 12.550. FM group: tNDIS=9.921, 14.400 and 17.640, tPHQ-9=4.032, 6.106 and 7.781, tGAD-7=4.638, 5.993 and 8.840, tPSQI=5.289, 8.199 and 10.310, all P<0.05). At two, four and eight weeks after treatment, NDIS, GAD-7 and PSQI scores of AO group were all lower than those of the FM group during the same period (NDIS: 13.73±0.53 vs. 15.33±0.58, 10.13±0.44 vs. 11.58±0.50, 7.87±0.31 vs. 9.80±0.35; GAD-7: 6.36±0.30 vs. 7.27±0.31, 5.29±0.28 vs. 6.51±0.32, 4.21±0.19 vs. 5.21±0.27; PSQI: 6.64±0.37 vs. 8.01±0.33, 5.27±0.35 vs. 6.76±0.32, 4.09±0.30 vs. 5.78±0.32), and the differences were statistically significant ( tNDIS=2.018, 2.225 and 4.156, tGAD-7=2.097, 2.869 and 2.536, tPSQI=1.951, 2.359 and 3.099, all P<0.05). At eight weeks after treatment, the total effective rate of the AO group was higher than that of the FM group (94.9%, 93/98 vs. 84.9%, 73/86), and the difference was statistically significant ( χ2=5.205, P=0.026). The incidence of adverse reactions of constipation and somnolence of the AO group were both lower than those of the FM group (2.0%, 2/98 vs. 9.3%, 8/86 and 1.0%, 1/98 vs. 8.1%, 7/86, respectively), and the differences were statistically significant ( χ2=4.699 and 5.582, P=0.047 and 0.027). Conclusion:AO may be a treatment option for PDS with depression, anxiety and sleep disorders.

Observation on therapeutic effect of acupuncture at "experienced ten acupoints" for postprandial distress syndrome / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture at "experienced ten acupoints" for postprandial distress syndrome.@*METHODS@#A total of 62 patients with postprandial distress syndrome were randomly divided into an observation group (31 cases, 5 cases dropping off) and a control group (31 cases, 6 cases dropping off ). Acupuncture was applied at Baihui (GV 20), Zhongwan (CV 12), Qihai (CV 6), Tianshu (ST 25), Neiguan (PC 6), Zusanli (ST 36), Gongsun (SP 4), Danzhong (CV 17) in the observation group. In the control group, 6 non-acupoint points were intervened with shallow puncture. The treatment was given 20 min each time, once every other day, 3 times a week for a total of 4 weeks in the two groups. Symptom index of dyspepsia (SID) and Nepean dyspepsia index (NDI) scores were compared before and after treatment, and the efficacy was evaluated in the two groups.@*RESULTS@#The effective rate in the observation group was 76.9% (20/26), which was higher than 28.0% in the control group (7/25, <0.01). After treatment, the SID and NDI scores in the two groups were lower than those before treatment (<0.01, <0.05), and the SID and NDI scores in the observation group were lower than those in the control group (<0.01, <0.05).@*CONCLUSION@#Acupuncture at "experienced ten acupoints" can significantly reduce the symptoms of dyspepsia and improve the quality of life in patients with postprandial distress syndrome.

A Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial of Qi-Zhi-Wei-Tong Granules on Postprandial Distress Syndrome-Predominant Functional Dyspepsia / 中华医学杂志(英文版)

<p><b>Background</b>Functional dyspepsia (FD) is a common upper gastrointestinal disorder worldwide, but the current treatments for FD are still unsatisfactory. The aims of this study were to investigate the efficacy and safety of Qi-Zhi-Wei-Tong granules in patients with postprandial distress syndrome (PDS)-predominant FD.</p><p><b>Methods</b>The study was conducted as a randomized, double-blinded, multicenter, placebo-controlled design in 197 patients with PDS. All participants received placebo treatment for 1 week. Patients whose total symptom score decreased by <50% after the placebo treatment were recruited into the 4-week treatment period, in which they were randomly assigned to be treated with either Qi-Zhi-Wei-Tong granules or placebo. The patients were then followed for 2 weeks without any treatment. Dyspeptic symptoms were scored at weeks 2 and 4 during the random treatment period and 2 weeks after the treatment. Anxiety and depression symptoms were also scored and compared.</p><p><b>Results</b>(1) The total effective rates in the Qi-Zhi-Wei-Tong granules group at weeks 2 and 4 during the random treatment period and 2 weeks after treatment were all significantly higher than those in the placebo group (38.82% vs. 8.75%, P < 0.001; 69.14% vs. 16.25%, P < 0.001; 77.65% vs. 21.25%, P < 0.001). (2) The total dyspeptic symptoms scores in the Qi-Zhi-Wei-Tong granules group at weeks 2 and 4 and 2 weeks after treatment were significantly lower than those in the placebo group. (3) The severity and frequency of each dyspeptic symptom at weeks 2 and 4 and the follow-up period were all significantly lower than those in the placebo group. (4) The anxiety scores in the Qi-Zhi-Wei-Tong granules group were significantly lower than those in the placebo group. (5) Qi-Zhi-Wei-Tong granules did not have more adverse effects than the placebo.</p><p><b>Conclusion</b>Qi-Zhi-Wei-Tong granules offer significant symptomatic improvement in PDS with no more adverse effects than placebo.</p><p><b>Trial Registration</b>https://clinicaltrials.gov/, NCT02460601.</p>

A study on the role of small intestinal bacterial overgrowth in patients with functional dyspepsia

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.

Correlación entre síntomas gastrointestinales funcionales y la histopatología de la mucosa gástrica, incluyendo la infección por Helicobacter pylori, en Lima, Perú / Correlation between functional gastrointestinal disorders and gastric mucosa histopathology findings, including Helicobacter pylori infection, in Lima, Peru

This study aims to investigate the relationship between functional gastrointestinal disorders and histopathology characteristics, including H. pylori infection, of gastric mucosa, at Cayetano Heredia National Hospital, Lima-Peru, in 2013. Materials and methods: 112 patients were interviewed prospectively between June and July 2013 in the gastroenterology service. Dyspepsia, irritable bowel syndrome, and postprandial distress syndrome were characterized using the Rome III Survey. Results: Pathology results were determined by gastric biopsies obtained by endoscopy. Of the patients interviewed, biopsy results were obtained for 101. 22.8% had atrophy, 24.8% had intestinal metaplasia, 57.4% presented with H pylori. Conclusions: Using chisquare analysis, no statistically significant relationship could be identified between clinical presentation and biopsy results...

El objetivo de este estudio fue investigar la correlación que existe entre la presencia de síntomas gastrointestinales y los hallazgos histopatológicos de la biopsia gástrica incluyendo la presencia de la infección por Helicobacter pylori. Materiales y métodos: Este estudio prospectivo comprendió a 112 pacientes que se incluyeron entre junio y julio de 2013 en el Servicio de Gastroenterología del Hospital Nacional Cayetano Heredia, Lima-Perú a los que se les hizo endoscopía y biopsia gástrica. Los síntomas de dispepsia, síndrome de intestino irritable y síndrome de distrés post prandial fueron obtenidos usando las encuestas de Roma III. Resultados: De los pacientes a los que se les hizo la encuesta sólo en 101 se les evaluó la biopsia. 22,8% tuvo atrofia, 24,8% presentó metaplasia intestinal, y en 57,4% se reportó la infección por Helicobacter pylori. Conclusiones: Usando el análisis con chi-cuadrado no se pudo establecer ninguna correlación estadísticamente significativa entre la presentación clínica y los resultados de las biopsias...

Characteristics of liquid food distribution in the stomach of 52 patients with postprandial distress syndrome-predominated functional dyspepsia / 中华消化杂志

Objective To explore the distribution of the liquid food in the stomach of patients with postprandial distress syndrome (PDS)-predominated functional dyspepsia (FD)and the mechanism of its gastric dynamic dysfunction.Methods Fifty-two patients with PDS and 18 healthy volunteers underwent gastric emptying examination with ultrasound scanner provided.The proximal and distal gastric area and volume,area and volume ratio of proximal and distal gastric as well as emptying rate of proximal and distal gastric were calculated at fasting,maximum satiety,30 min,60 min,90 min and 120 min after meal. Student′s t test andχ2 test were performed for statistical analysis.Results Proximal gastric volume of PDS group at the time of fasting and 120 min after meal were (9.06±7.88)and (24.72±24.02)cm3 ,which were larger than those of healthy control group ((5 .96 ± 2.13 )cm3 ,(19.48 ± 12.32 )cm3 ),and the differences were statistically significant (t=-1 .637 and -0.875 ,both P distal gastric volume in PDS group and healthy group at fasting was 0.60 ± 0.38 and 0.46 ± 0.19, respectively,that at maximum satiety was in PDS group and healthy group 0.91 ±0.27,1 .30 ±0.48, respectively,and the differences were statistically significant (t = - 1 .505 and 3.970,both P 0.05 ).Conclusions The volume of distal stomach was larger than that of proximal stomach in PDS patients at maximum satiety in liquid food distribution,which may be the cause of decreasing emptying rate of proximal stomach.And proximal stomach dominated gastric motility in PDS patients.

Efficacy and safety of Jianwei xiaoshi oral liquid combined with mosapride on treating postprandial distress syndrome / 中国综合临床

Objective To investigate the clinical efficacy and safety of Jianwei xiaoshi oral liquid combined with mosapride on treating postprandial distress syndrome( PDS ). Methods Eighty cases patients with PDS diagnosed according to Rome-Ⅲ PDS diagnostic criteria were randomly assigned into treatment group and control group. Patients in treatment group were treated with jianwei xiaoshi oral liquid( 1 bottle/times,3 tiems/d,after meals)and mosapride,and in the control group were taken mosapride(5 mg/times,3 times/d, before meals)only for 4 weeks. After the end of treatment,the improvement of the symptoms,the total symptoms score,the total effective rate and adverse drug reaction were recorded. Results After the treatment,symptoms were relieved in both groups. The total symptoms score of the treatment group was(2. 90 ± 1. 39)scores,lower than that in before((11. 14 ± 1. 86)scores),and the difference was significant(t=22. 328,P﹤0. 01). The total symptoms score in treatment group was(2. 90 ± 1. 39)scores,significantly lower than the control group((4. 94 ±2. 03)scores;t =5. 217,P ﹤0. 01). The total effective rate was 87. 80%(36/41),66. 67%(26/39)in treatment and control group,and the difference was significant( t=5. 122,P﹤0. 05). There was no significant in terms of adverse drug reaction in two groups during the treatment. Conclusion Jianwei xiaoshi oral liquid combined with mosapride is a safe and effective treatment of PDS patients,which is better than using mosapride alone.

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

BACKGROUND/AIMS: It remains unclear whether atrophic gastritis can affect dyspeptic symptoms. We aimed to investigate whether the extent of atrophic gastritis is associated with specific dyspeptic symptoms. METHODS: Consecutive adults in a routine health-checkup program were enrolled in the study. The extent of atrophic gastritis was classified into 3 groups based on the Kimura-Takemoto criteria; the gastritis with no or little atrophy (group A: C0), the gastritis with atrophy mainly in the antrum (group B: C1 and C2), and the gastritis with atrophy in the large area of the corpus (group C: C3 and O). Upper gastrointestinal symptoms were categorized into "typical reflux symptoms," "epigastric pain syndrome (EPS)-related symptoms," and "postprandial distress syndrome (PDS)-related symptoms." RESULTS: A total of 1827 patients (1009 males, mean age 45.1 years) were included in the analysis. The subgroups of atrophic gastritis were as follows: group A (n = 1218, 66.7%), group B (n = 392, 21.4%), and group C (n = 217, 11.9%). Typical reflux, EPS-related, and PDS-related symptoms were present in 10.5%, 19.8%, and 16.2% of the subjects, respectively. PDS-related and EPS-related symptoms were significantly more prevalent in the group C of male patients and the group B of female patients, respectively, compared with other groups. PDS-related and EPS-related symptoms were independently associated with the group C in males (OR, 2.123; 95% CI, 1.090-4.136) and the group B in females (OR, 2.571; 95% CI, 1.319-5.025), respectively. CONCLUSIONS: The extent of atrophic gastritis appears to affect the generation of specific dyspeptic symptoms in a gender-dependent manner.

Overlap Syndrome of Functional Dyspepsia and Irritable Bowel Syndrome - Are Both Diseases Mutually Exclusive?

Among functional gastrointestinal (GI) disorders, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are important to public health around the world and are frequently encountered in general practice. Upper GI symptoms such as heartburn, postprandial fullness, early satiety, epigastric pain or burning and lower GI symptoms such as constipation and diarrhea often coexist. Although the prevalence of FD-IBS overlap would be influenced by the selection of the study population, the overlap rate of FD-IBS could be in the range of 11%-27%. Specifically, FD-IBS overlap is associated with more severe symptoms than FD alone or IBS alone. Since clinical overlap, especially FD-IBS overlap, is very common, the 2 syndromes should not be treated in a mutually exclusive fashion.