Central neuromodulators for patients with functional esophageal disorders: A systematic review and meta-analysis.

Autor: Yeh JH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA DaChang Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Medical technology, College of Medicine, I-Shou University, Kaohsiung, Taiwan., Chen CL; Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan., Sifrim D; Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Fass R; The Esophageal and Swallowing Center, MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH, USA., Wang WL; Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan., Hsu CC; Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan., Lei WY; Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan. Electronic address: raylei0122@gmail.com.
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2024 Oct; Vol. 56 (10), pp. 1675-1682. Date of Electronic Publication: 2024 Jun 08.
DOI: 10.1016/j.dld.2024.05.013
Abstrakt: Backgroud: The use of neuromodulators is prevalent in various functional gastrointestinal disease. However, data concerning the outcomes of these treatments in functional esophageal disorders (FED) remains limited and inadequate.
Aims: The aim of the present study is to examine the efficacy of central neuromodulators in FED.
Methods: We searched PubMed, EMBASE, and the Cochrane library databases from inception to April 2023. Randomized controlled trials that compared the effects of neuromodulators and placebos on FED are included. Primary outcome is the symptom improvement, and Rome IV criteria is used to assess eligible studies.
Results: Eleven randomized controlled studies (three for functional chest pain, four for reflux hypersensitivity/functional heartburn, three for globus, and one for functional dysphagia) were included in the final analysis. Neuromodulators reduced chest pain by 52%-71% in patients with functional chest pain, and alleviated symptom by 46%-75% in patients with globus (n = 3, Odds ratio 6.30, 95% confidence interval 4.17-9.50). However, the results were inconsistent for reflux hypersensitivity and functional heartburn. There was a lack of convincing evidence to support the use of neuromodulators for functional dysphagia. The use of neuromodulators did not have a significant impact on the quality of life.
Conclusions: Functional chest pain and globus may potentially benefit from the use of neuromodulators, but their effectiveness for functional dysphagia, functional heartburn and reflux hypersensitivity remains controversial. More controlled trials are needed to confirm the therapeutic effects on these conditions.
Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to declare.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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