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Titolo:
Current indications for acid suppressants in dyspepsia
Autore:
Bytzer, P; Talley, NJ;
Indirizzi:
Univ Sydney, Nepean Hosp, Dept Med, Penrith, Australia Univ Sydney Penrith Australia Nepean Hosp, Dept Med, Penrith, Australia Glostrup Univ Hosp, Div Gastroenterol, Dept Med, Glostrup, Denmark Glostrup Univ Hosp Glostrup Denmark nterol, Dept Med, Glostrup, Denmark
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 3, volume: 15, anno: 2001,
pagine: 385 - 400
SICI:
1521-6918(200106)15:3<385:CIFASI>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
NON-ULCER DYSPEPSIA; SINGLE-SUBJECT TRIALS; FUNCTIONAL DYSPEPSIA; GENERAL-PRACTICE; DOUBLE-BLIND; NONULCER DYSPEPSIA; CLINICAL-DIAGNOSIS; PRIMARY-CARE; CIMETIDINE; OMEPRAZOLE;
Keywords:
H-2-receptor antagonists; proton pump inhibitors; dyspepsia; functional dyspepsia; management; controlled trials;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
63
Recensione:
Indirizzi per estratti:
Indirizzo: Talley, NJ Univ Sydney, Nepean Hosp, Dept Med, Penrith, Australia Univ Sydney Penrith Australia , Dept Med, Penrith, Australia
Citazione:
P. Bytzer e N.J. Talley, "Current indications for acid suppressants in dyspepsia", BEST PR RES, 15(3), 2001, pp. 385-400

Abstract

Anti-secretory drug use is common in patients with uninvestigated and functional dyspepsia, but the value of such agents has been controversial. Fourlarge studies have evaluated the symptomatic outcome after a short course of acid inhibition in patients with uninvestigated dyspepsia presenting in primary care. All of these studies demonstrated a superior symptom responseto proton pump inhibitor therapy compared with placebo and acid-alginates or H-2-receptor antagonists. In patients with documented functional dyspepsia, 17 parallel group trials have evaluated an H-2-receptor antagonist against placebo, with mixed results. A recent Cochrane review based on eight controlled trials concluded that there was a significant benefit of H-2-blockers over placebo with a relative risk reduction of 30%, but as gastro-oesophageal reflux disease was nor, excluded, the conclusions are questionable. Six controlled studies have compared symptom relief after a short course ofproton pump inhibitor therapy compared with placebo. Overall, there does appear to be a therapeutic gain with proton pump inhibitors over placebo, although how much of this is explained by undiagnosed gastro-oesophageal reflux disease remains unclear. There is conflicting evidence on the value of symptom subgrouping as a predictor of response to acid suppression. Overall,there is little convincing evidence that Helicobacter pylori infection influences the therapeutic outcome of acid-suppressant therapy. In conclusion,there appears to be a subgroup of patients with functional dyspepsia who will respond to acid suppression over and above placebo, but further work isrequired to characterize these responders.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 11:37:32