Functional dyspepsia: diagnostic and therapeutic options
Journal Title: Сучасна гастроентерологія - Year 2018, Vol 0, Issue 2
Abstract
Objective — to study the effects of digestive enzymes on the symptoms of functional dyspepsia FD and the state of gastric motility. Materials and methods. Observations involved 60 patients with FD (21 men and 39 women, the mean age 44.2 ± 3.0 years). The study population included only patients with postprandial distress syndrome PDS (n = 33) and mixed form (n = 27). The FD diagnosis and its forms were established on the basis of the IV Rome Criteria. The severity of the symptoms was determined quantitatively on the 5 cm visual analog scale (VAS). In all patients prior to the start of treatment, an ultrasound test with a drinking load was performed to assess gastric motility and visceral hypersensitivity parameters. After this, the patients were randomized into two groups, matching by sex, age and dyspepsia form. The first group included 30 patients received a vegetative enzyme preparation «Sanzyme» 1 tablet 3 times daily with meals and itopride hydrochloride 50 mg three times. In the second comparison group, 30 patients received only itopride hydrochloride in a same dose. Results. After 4 weeks of treatment patients of the first group demonstrated reduction of dyspepsia index (DI) by 61 %, up to 0.92 ± 0.45 cm (p = 0.044), and in the second group by 35 % up to 1.59 ± 0.42 cm, however in the second this reduction was not significant in comparison with the baseline indices (p = 0.24). Moreover, the positive dynamics of the indicators of drinking ultrasound samples has been established. In the first group of patients, a significant improvement in accommodation was observed, which was manifested by an increase in the growth of the area of the S1 stomach by 31 %, to 37.2 ± 3.1 cm2 (p = 0.042). In the second group, the increment S1 was 11 % (up to 33.5 ± 3.4 cm2) and was insignificant (p = 0.4). Besides, in patients of the first group, the acceleration of evacuation from the stomach at the 5th minute was revealed (S2 decreased by 23 % up to 81.2 ± 8.3 cm2, (p = 0.047)). At the same time, in the second group, S2 decreased by 18 % up to 85.1 ± 7.9 cm (p = 0.094). The visceral sensitivity in the first group decreased by 77 % up to 0.56 ± 0.47 points (p = 0.026), and in the second group, visceral sensitivity decreased by 60 % to 0.88 ± 0.35 points (p = 0.037). Conclusions. In patients with postprandial distress syndrome and a mixed form of functional dyspepsia, the use of the vegetative enzyme preparation Sanzym allowed achieving of the significant improvement in gastric accommodation, evacuation of fluid from the stomach and reduction of visceral hypersensitivity, which was accompanied by a significant decrease in the severity of clinical symptoms.
Authors and Affiliations
A. E. Dorofeyev, N. N. Rudenko, T. E. Kugler, T. P. Snisarevskaya
Keywords
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