Proton Pump Inhibitors: Effective First-Line Treatment for Management of Dyspepsia
| Autor: | Nancy Y. Siepman, James W. Freston, Betsy L. Pilmer, David A. Peura, Jeff Gudmundson |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Physiology medicine.drug_class Lansoprazole Proton-pump inhibitor Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles law.invention Double-Blind Method Symptom relief Randomized controlled trial law Internal medicine medicine Humans Dyspepsia Enzyme Inhibitors Irritable bowel syndrome business.industry Patient Selection Heartburn Proton Pump Inhibitors Hepatology Anti-Ulcer Agents medicine.disease digestive system diseases First line treatment medicine.symptom business medicine.drug |
| Zdroj: | Digestive Diseases and Sciences. 52:983-987 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-006-9156-7 |
| Popis: | The aim of this study was to evaluate the reasons for trial exclusion among dyspeptic patients and estimate the proportion that may have benefited from proton pump inhibitor (PPI) therapy. Stringent inclusion criteria for enrollment in two multicenter functional dyspepsia trials included dyspepsia (predominant persistent/recurrent upper abdominal discomfort [UAD] during the prior 3 months) of at least moderate intensity during > or =30% of days during the prior 2 to 3 weeks. Exclusion criteria were mild/infrequent UAD; heartburn and UAD of equal frequency; predominant heartburn with UAD; endoscopic evidence of erosive esophagitis or Barrett's or gastric and/or duodenal erosions (>5) or ulcers; irritable bowel syndrome (IBS); other gastrointestinal diagnoses; or other "non-categorized" disorders. Of 2,588 screened patients, 1,667 were excluded. Excluded patients by category had mild/infrequent UAD (12.5%, n=324), heartburn and UAD of equal frequency (1.1%, n=29), predominant heartburn with UAD (11.6%, n=300), endoscopic evidence of erosive esophagitis or Barrett's (6.2%, n=160), gastric and/or duodenal erosions (1.4%, n=36), gastric and/or duodenal ulcers (2.0%, n=53), IBS (7%, n=180), "other" gastrointestinal diagnoses (2.8%, n=73), or other "non-categorized" disorders (19.8%, n=512). Fifty-four percent of patients (902/1,667) had symptoms/diagnoses that would be expected to improve with PPI therapy. Individuals with IBS, "other," or "non-categorized" disorders were considered to have symptoms unlikely to respond to PPI treatment. Empiric PPI treatment would be expected to provide symptom relief to the majority of dyspepsia sufferer who present in clinical practice. PPIs represent the best currently available therapy for acid-related disorders and should be considered the first-line management approach in patients with uninvestigated dyspepsia. |
| Databáze: | OpenAIRE |
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