scholarly journals Acotiamide: a novel drug for the treatment of patients with functional dyspepsia

2017 ◽  
Vol 6 (6) ◽  
pp. 1238
Author(s):  
Amit Bhalla
Keyword(s):  
Functional Dyspepsia ◽  
Delayed Gastric Emptying ◽  
Elimination Rate ◽  
Acetylcholinesterase Activity ◽  
Abdominal Symptoms ◽  
Receptor Inhibition ◽  
Prokinetic Drug ◽  
Rome Iii ◽  
Novel Drug ◽  
Upper Gastrointestinal

Functional dyspepsia (FD) is a highly prevalent condition with major socioeconomic and healthcare impact. Previously, no pharmacotherapeutic agent had approved for the treatment of this condition. Acotiamide, a new first-in-class oral prokinetic drug, is an upper gastrointestinal motility modulator for the treatment of abdominal symptoms resulting from hypomotility and delayed gastric emptying in patients with functional dyspepsia. It exerts its activity in the stomach via muscarinic receptor inhibition, resulting in enhanced acetylcholine release and inhibition of acetylcholinesterase activity. Unlike other prokinetic drugs that are utilized in the management of functional dyspepsia, acotiamide shows little/no affinity for serotonin or dopamine D2 receptors. Acotiamide is the world’s first approved treatment for functional dyspepsia diagnosed by Rome III criteria, with its first approval occurring in Japan. A favourable clinical course with acotiamide 100mg t.i.d was demonstrated with high symptom elimination rate for patients of FD.

Functional Dyspepsia and Gastroparesis

2016 ◽  
Vol 34 (5) ◽  
pp. 491-499 ◽  
Author(s):  
Michael Camilleri
Keyword(s):  
Gastric Emptying ◽  
Functional Dyspepsia ◽  
Delayed Gastric Emptying ◽  
Gastrointestinal Symptoms ◽  
Psychological Disorder ◽  
Mechanical Obstruction ◽  
Gastric Accommodation ◽  
Postprandial Fullness ◽  
Rumination Syndrome ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal disorders typically present with common symptoms. The most relevant non-mucosal diseases are gastroparesis, functional dyspepsia and rumination syndrome. The literature pertaining to these 3 conditions was reviewed. Key Messages: Gastroparesis is characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The cardinal symptoms include postprandial fullness (early satiety), nausea, vomiting and bloating. The most frequently encountered causes of these symptoms are mechanical obstruction (pyloric stenosis), iatrogenic disease, gastroparesis, functional dyspepsia, cyclical vomiting and rumination syndrome. The most common causes of gastroparesis are neuropathic disorders such as diabetes, idiopathic, post-vagotomy and scleroderma among myopathic disorders. Principles of management of gastroparesis include exclusion of mechanical obstruction with imaging and iatrogenic causes with careful medication and past surgical history. Prokinetics and anti-emetics are the mainstays of treatment. Functional dyspepsia is characterized by the same symptoms as gastroparesis; in addition to delayed gastric emptying, pathophysiological abnormalities include accelerated gastric emptying, impaired gastric accommodation and gastric or duodenal hypersensitivity to distension and nutrients. Novel treatments include tricyclic antidepressants in patients with normal gastric emptying, acotiamide (acetyl cholinesterase inhibitor) and 5-HT1A receptor agonists such as buspirone. Rumination syndrome is characterized by repetitive regurgitation of gastric contents occurring within minutes after a meal. Episodes often persist for 1-2 h after the meal, and the regurgitant consists of partially digested food that is recognizable in its taste. Regurgitation is typically effortless or preceded by a sensation of belching. This has been summarized as a ‘meal in, meal out, day in, day out' behavior for weeks or months, differentiating rumination from gastroparesis. Patients often have a background of psychological disorder or a prior eating disorder. Treatment is based on behavioral modification. Conclusion: Precise identification of the cause and pathophysiology of upper gastrointestinal symptoms is essential for optimal management.

scholarly journals Diagnosis of Functional Dyspepsia on the basis of Rome III clinical diagnostic criteria in a tertiary care hospital: A cross-sectional observational study

2018 ◽  
Vol 9 (1) ◽  
pp. 55-60
Author(s):  
Kaushik Biswas ◽  
Rajdip Hazra ◽  
Sisir Chakraborty ◽  
Rajarshi Bose ◽  
Swadesh Garain
Keyword(s):  
Diagnostic Criteria ◽  
Functional Dyspepsia ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Rome Iii Criteria ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Abdominal Symptoms ◽  
Rome Iii

Background: Though functional dyspepsia (FD) is often a diagnosis of exclusion, whether minor mucosal gut pathology represents organic disease or FD, it still remains controversial.Aims and Objectives: The present study has been conducted to determine the accuracy of symptom based diagnosis of FD based on Rome III diagnostic criteria in a tertiary care center.Materials and Methods: Total 140 patients aged between 18-55 years of both sexes with upper abdominal symptoms without known or post investigational organic diseases, were included in this study. Patients fulfilling the Rome III criteria were diagnosed as FD and undergone upper GI endoscopy (UGIE). Those devoid of organic lesions were confirmed as ‘true FD’.Results: Out of 140 study patients, 100 patients fulfilled Rome III criteria (clinical FD) out of which 77 were confirmed as ‘true FD’ after UGIE with an accuracy of 83.57 %.Conclusion: Rome III clinical criteria can be applied to diagnose FD in a tertiary care center with some limitations. The authors suggest some modification of Rome III criteria.Asian Journal of Medical Sciences Vol.9(1) 2018 55-60

scholarly journals Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses

2021 ◽  
Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps
Keyword(s):  
Diagnostic Criteria ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Final Analysis ◽  
Gastrointestinal Disorders ◽  
Rome Iii ◽  
Sample Characteristics ◽  
Irritable Bowel ◽  
Rome Iv

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.

scholarly journals Impaired vagal activity to meal in patients with functional dyspepsia and delayed gastric emptying

2017 ◽  
Vol 46 (2) ◽  
pp. 792-801 ◽  
Author(s):  
W-J Guo ◽  
S-K Yao ◽  
Y-L Zhang ◽  
S-Y Du ◽  
H-F Wang ◽  
...  
Keyword(s):  
Spectral Analysis ◽  
Gastric Emptying ◽  
Functional Dyspepsia ◽  
Delayed Gastric Emptying ◽  
Low Frequency ◽  
Treatment Method ◽  
Frequency Component ◽  
High Frequency Component ◽  
Vagal Activity ◽  
Nervous Function

Objective This study was performed to investigate impaired vagal activity to meal in patients with functional dyspepsia (FD) with delayed gastric emptying (GE). Methods Eighty-five patients were studied. GE parameters, including those in the overall and proximal stomach, were measured by GE functional tests at the Department of Nuclear Medicine. Autonomic nervous function was tested by spectral analysis of heart rate variability (HRV). The vagal activity and sympathetic activity were analyzed by recording the power in the high-frequency component (HF), low-frequency component (LF), and LF/HF ratio. Results Overall and proximal GE were delayed in 47.2% and 50.9% of the patients, respectively. Spectral analysis of HRV showed that the HF in patients with delayed proximal GE was significantly lower and that the LF/HF ratio was significantly higher than those in patients with normal proximal GE after a meal. Conclusion Delayed proximal GE might be caused by disrupted sympathovagal balance as a result of decreased vagal activity after a meal. Improvement in vagal activity may constitute an effective treatment method for patients with FD.

Psychological distress in Rome III functional dyspepsia patients presenting for testing of gastric emptying

2015 ◽  
Vol 28 (2) ◽  
pp. 196-205 ◽  
Author(s):  
J. K. Dibaise ◽  
R. S. Islam ◽  
A. C. Dueck ◽  
M. C. Roarke ◽  
M. D. Crowell
Keyword(s):  
Psychological Distress ◽  
Gastric Emptying ◽  
Functional Dyspepsia ◽  
Rome Iii

Pathophysiological Abnormalities in Functional Dyspepsia Subgroups According to the Rome III Criteria

2017 ◽  
Vol 112 (1) ◽  
pp. 132-140 ◽  
Author(s):  
H Vanheel ◽  
F Carbone ◽  
L Valvekens ◽  
M Simren ◽  
H Tornblom ◽  
...  
Keyword(s):  
Functional Dyspepsia ◽  
Rome Iii Criteria ◽  
Rome Iii

ROME III Functional Dyspepsia Criteria: Substantial Symptom Overlap With GERD Questions Their Validity

2011 ◽  
Vol 140 (5) ◽  
pp. S-188 ◽  
Author(s):  
Nimish B. Vakil ◽  
Katarina Halling ◽  
Börje Wernersson ◽  
Lis Ohlsson
Keyword(s):  
Functional Dyspepsia ◽  
Rome Iii ◽  
Symptom Overlap

scholarly journals The Gastro-protective Effect of Ginger (Zingiber officinale Roscoe) in Helicobacter pylori Positive Functional Dyspepsia

2019 ◽  
Vol 9 (2) ◽  
pp. 321-324 ◽  
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Mohammad Hosein Somi ◽  
Mohammad Asghari Jafarabadi ◽  
Alireza Ostadrahimi ◽  
Seyed-Yaghob Moaddab ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Helicobacter Pylori ◽  
Functional Dyspepsia ◽  
Zingiber Officinale ◽  
Complementary Therapy ◽  
Positive Functional ◽  
Before And After ◽  
Rome Iii ◽  
Ginger Powder ◽  
H Pylori

Purpose: The present study aimed to assess the effect of ginger (Zingiber officinale) powder supplementation on Helicobacter pylori eradication and improvement of dyspeptic symptoms in patients with H. pylori positive functional dyspepsia (FD). Methods: During this pilot study 15 patients with H. pylori positive FD received 3 g/d ginger powder as three 1-g tablets for 4-weeks. Dyspepsia symptoms were asked before and after the intervention using a questionnaire based on the Rome III criteria. H. pylori eradication was also assessed by a non-invasive stool antigen (HpSAg) test. Results: Ginger consumption accompanied by significant H. pylori eradication rate of 53.3% (P = 0.019) and the odds ratio (95% CI) was 8 (1.07 to 357.14). Moreover, our results showed significant changes in most of the dyspepsia symptoms after ginger supplementation. Conclusion: According to our findings, Z. officinale can be considered as a useful complementary therapy for FD. However, due to the small number of clinical trials in this area, further welldesigned clinical trials are needed to explicitly talk about its effectiveness especially about the eradication of H. pylori.

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