• Bloating
• Chronic constipation
• Disorders of gut–brain interaction
• Functional dyspepsia
• Gonadal Steroid Hormones
• Irritable bowel syndrome
• Postmenopause
• Premenopause
• Sex Characteristics
• Visceral Hypersensitivity

• Humans
• Female
• Middle Aged
• Male
• Adult
• Menopause/physiology
• Sex Characteristics
• Brain-Gut Axis/physiology
• Aged
• Constipation/physiopathology
• Constipation/epidemiology
• Menstruation/physiology
• Gastrointestinal Diseases/physiopathology
• Gastrointestinal Diseases/epidemiology
• Dyspepsia/physiopathology

• U54 DK123755 NIDDK NIH HHS
• Rome Foundation
• NIH HHS
• NIH HHS
• Rome Foundation
• National Institutes of Health

• Gastric peroral endoscopic myotomy (G-POEM)
• Gastroesophageal reflux disease questionnaire (GERDQ)
• Gastroparesis cardinal symptom index (GCSI)
• Postoperative gastroparesis
• Three-dimensional ultrasound

• Humans
• Gastroparesis/etiology
• Gastroparesis/surgery
• Female
• Male
• Middle Aged
• Adult
• Follow-Up Studies
• Postoperative Complications/etiology
• Gastric Emptying
• Treatment Outcome
• Myotomy/methods
• Natural Orifice Endoscopic Surgery/methods
• Natural Orifice Endoscopic Surgery/adverse effects
• Gastroscopy/methods
• Aged
• Pyloric Antrum/surgery
• Pyloric Antrum/diagnostic imaging
• Pyloromyotomy/methods

• M2022093 General Program Foundation of Jiangsu Province health committee
• ZT202120 Foundation of Jiangsu Province Traditional Chinese Medicine Administration

• cognitive-behavioral therapy
• functional dyspepsia
• hypnotherapy
• mindfulness-based stress reduction
• psychotherapy

• Humans
• Dyspepsia/therapy
• Dyspepsia/psychology
• Quality of Life
• Cognitive Behavioral Therapy/methods
• Psychotherapy/methods
• Randomized Controlled Trials as Topic
• Depression/therapy
• Anxiety/therapy
• Anxiety/etiology
• Hypnosis/methods
• Mindfulness/methods
• Treatment Outcome

• Duodenum
• Functional Dyspepsia
• Inflammation

• gastric accommodation
• gastric sensorimotor function
• nutrient tolerance
• prucalopride
• serotonin agonist

• eating behaviors
• ghrelin
• glycemia
• insulin
• mathematical modeling
• meal modeling

• Appetite
• Eating
• Humans
• Meals
• Models, Theoretical
• Nutrition Surveys

Artemisia rupestris L. is the perennial herb of rupestris belonging to Artemisia (Compositae), which is wildly distributed in Xinjiang (China), middle Asia, and Europe. It is known to have anti-inflammatory, hepatoprotective, immune function regulation, and gastrointestinal function regulation effects. AR is used to treat digestive diseases, but the effects of AR on antifunctional dyspepsia (FD) activity have not yet been reported. In this study, we aimed to investigate the therapeutic effects of Artemisia rupestris L. extract (ARE) on gastrointestinal hormones and brain-gut peptide in functional dyspepsia (FD) rats. Sixty Sprague-Dawley rats were randomly divided into 6 groups. An FD rat model was established by irregular tail clamp stimulation for 14 days except the blank group. After FD rat models, the blank group and model group were given menstruum, and the medicated rats were given corresponding medicine for 14 days. The general observations, bodyweight, and food intake were observed, and the content of serum gastrin (GAS), plasma motilin (MTL), plasma vasoactive intestinal peptide (VIP), and plasma somatostatin (SS) by the enzyme-linked immunosorbent assay was observed. The content of plasma VIP and plasma SS in the ARE group was significantly lower than in the model group, and the content of serum GAS and plasma MTL was increased in the ARE group; the GAS expression of antrum and hypothalamus was increased in the ARE group, and SS expression of antrum and hypothalamus was decreased in the ARE group by immunohistochemical detection; the results of semiquantitative reverse transcription polymerase chain reaction (RT-PCR) indicate that ARE inhibits the mRNA expression of VIP. Our results suggest that ARE can recover gastrointestinal hormone levels and regulation of the peripheral and central nervous system and alter gut peptide levels, which confirm the therapeutic effect of ARE on functional dyspepsia.

The pathophysiology underlying functional dyspepsia (FD) is multifactorial and focuses on gastric sensorimotor dysfunction. Recent studies demonstrated that joint hypermobility syndrome (JHS) is strongly associated with unexplained dyspeptic symptoms in patients attending gastrointestinal clinics. We aimed to study the relationship between symptoms, gastric sensorimotor function, and JHS in FD patients.

Tertiary care FD patients who underwent a gastric barostat study and a gastric emptying breath test with 13C-octanoic acid were recruited for assessment of JHS. The presence of JHS was evaluated by a 2-phase interview and clinical examination that included major and minor criteria of the Brighton classification.

A total of 62 FD patients (68% women, age 44 ± 1.8 years, and body mass index: 21.7 ± 0.7 kg/m²) accepted to participate in the study. JHS was diagnosed in 55% of FD patients. Assessed symptom profiles during the visit did not differ between the groups. Delayed gastric emptying was not significantly more common in JHS group compared with non-JHS group (JHS group 32% vs non-JHS group 16%, P = 0.31). Prevalence of hypersensitivity to distention (JHS group 24% vs non-JHS group 29%, P = 0.76) and impaired gastric accommodation (JHS group 38% vs non-JHS group 42%, P = 0.79) was similar in patients with or without JHS. No correlations were found between the Beighton hypermobility score and gastric compliance (r = 0.09).

A large subset of this study cohort of tertiary care FD patients has coexisting JHS. We did not identify any specific differences in gastric sensorimotor function between patients with and without JHS. Further prospective research will be required to elucidate the relationship between JHS, a multisystemic disorder with widespread manifestations, and FD symptoms.

• G-POEM
• GCSI
• GERDQ
• Gastric emptying
• Postsurgical gastroparesis
• The anastomotic site

• Esophageal Achalasia
• Esophageal Sphincter, Lower
• Feasibility Studies
• Gastric Emptying
• Gastroparesis/etiology
• Gastroparesis/surgery
• Humans
• Pyloromyotomy/adverse effects
• Pylorus/surgery
• Retrospective Studies
• Treatment Outcome

• National Natural Science Foundation of China
• Young Medical Talents of Jiangsu Province

• Cannabinoid hyperemesis
• Functional dyspepsia
• Gastric emptying
• Opioids
• Rumination syndrome

• antral contractility
• fundic accommodation
• gastric emptying
• gastroparesis

• Enteric nervous system
• Functional gastrointestinal disorders
• Gastrointestinal hormones
• Irritable bowel syndrome
• Microbiome

This study was to investigate the association of psychological characteristics and functional dyspepsia treatment outcome. 109 patients who met the criteria for FD were enrolled. Eysenck Personality Questionnaire (EPQ), Symptom Checklist 90 (SCL90), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure personality, psychological symptoms, and sleep quality in our patients. Leeds Dyspepsia Questionnaire (LDQ) was used to assess dyspeptic symptoms at baseline and after eight weeks of treatment. The LDQ scores change after therapy, and the degraded rate of LDQ was used to assess the prognosis of patients. Logistic regression model was used to assess the effect of the personality, psychological symptoms, and sleep quality on the prognosis of patients. Our result revealed that poor sleep quality (OR = 7.68, 95% CI 1.83–32.25) and bad marriage status (OR = 1.22, 95% CI 1.10–1.36) had the negative effect on the prognosis of FD, while extroversion in personality traits (OR = 0.86, 95% CI 0.76–0.96) had positive effect on the prognosis of FD. We should pay attention to the sleep quality, the personality, and the marriage status of FD patients; psychological intervention may have benefit in refractory FD.

DA-9701 is a novel prokinetic agent. In the present study, we investigated the effect of DA-9701 on the motility of the gastric antrum in the normal and clonidine-induced hypomotility in an in vivo animal model.

A strain gauge force transducer was sutured on the gastric antrum to measure the contractile activity in rats. A total of 28 rats were subclassified into the 4 groups: (1) the placebo group, (2) the DA-9701 group, (3) the placebo group in the clonidine-pretreated rats, and (4) the DA-9701 group in the clonidine-pretreated rats. After the basal recording, either placebo (3% [w/v] hydroxypropylmethyl cellulose) or DA-9701 was administered. Contractile signals were measured after the administration and after a meal. In the clonidine-pretreated rats, either placebo or DA-9701 was administered. Contractile signals were measured after the administration and after a meal.

Oral administration of DA-9701 did not significantly alter the motility index of the gastric antrum in the preprandial and postprandial periods, compared with the placebo group. The administration of clonidine decreased the motility index of the gastric antrum in the preprandial and postprandial periods, compared with the administration of placebo. This reduction of the antral motility by the administration of clonidine was not observed in the clonidine-pretreated DA-9701 group. The percentage of the motility index in the postprandial period was significantly greater in the clonidine-pretreated DA-9701 group, compared with the clonidine-pretreated placebo group.

DA-9701 improves the hypomotility of the gastric antrum induced by clonidine, suggesting its gastroprokinetic effect in the pathologic condition.

• Antrum
• DA-9701
• Motility
• Prokinetic

Approximately 0.2–1 % of children suffers from abdominal migraine (AM). Pathophysiology of AM has not been adequately studied. This study evaluated gastric motility in children with AM.

Seventeen children (6 boys), within an age range of 4–15 years, referred to a tertiary care paediatric unit, North Colombo Teaching Hospital Ragama, Sri Lanka, from 2007 to 2012, were screened. Those fulfilling Rome III criteria for AM were recruited after obtaining parental consent. None had clinical or laboratory evidence of organic disorders. Twenty healthy children (8 boys), with an age range of 4–14 years, were recruited as controls. Liquid gastric emptying rate (GE) and antral motility parameters were assessed using an ultrasound method.

Average GE (41.6 % vs. 66.2 %, in controls), amplitude of antral contractions (A) (57.9 % vs. 89.0 %) and antral motility index (MI) (5.0 vs. 8.3) were lower and fasting antral area (1.8 cm² vs. 0.6 cm²) was higher in children with AM (p < 0.01). No significant difference in the frequency of antral contractions (F) (8.8/3 min vs. 9.3/3 min, p = 0.08) was found between the two groups. Scores obtained for severity of abdominal pain had a negative correlation with A (r = −0.55, p = 0.03). Average duration of abdominal pain episodes correlated with GE (r = −0.58, p = 0.02). Negative correlations were observed between duration of AM and A (r = −0.55), F (r = −0.52), and MI (r = −0.57) (p < 0.05).

GE and antral motility parameters were significantly lower in children with AM. A significant correlation was found between symptoms and gastric motility. These findings suggest a possible role of abnormal gastric motility in the pathogenesis of AM.

• acylated ghrelin
• gastric dysfunction
• rikkunshito
• stress
• urocortin1
• α2-adrenergic receptor

• epigastric pain syndrome
• functional dyspepsia
• postprandial distress
• syndrome

• Gastrointestinal hormones
• Gastrointestinal prokinetic effect
• Gentiopicroside
• Gentiopicroside (PubChem CID: 88708)
• Muscarinic acetylcholine receptor agonist

AIM: To assess effect of combination of symptoms, syndrome and disease on treatment of diabetic gastroparesis with severe nausea and vomiting.

METHODS: Professor Tong Xiaolin’s clinical electronic medical records of patients who were treated between January 1, 2006 and October 1, 2012 were used as a database. Patients who met the inclusion criteria were enrolled. General information (name, sex and age), symptoms and blood glucose levels were obtained from the clinic electronic medical record, which was supplemented by a telephone interview. The patient-rated Gastroparesis Cardinal Symptom Index (GCSI) was used to evaluate the severity of the symptoms of gastroparesis. The effects of the treatment were assessed by the change in the severity of the symptoms of gastroparesis and the change in blood glucose between the baseline levels and the post-treatment levels at 1, 2, 4, 8 and 12 wk.

RESULTS: Forty-five patients had a mean GCSI nausea and vomiting severity score of 4.21 ± 0.67 and a total GCSI score of 2.77 ± 0.63 before treatment. There was a significant improvement in the nausea and vomiting score at every return visit compared with the baseline score (1 wk: 3.02 ± 1.04 vs 4.18 ± 0.71, P < 0.001; 2 wk: 2.32 ± 1.25 vs 4.16 ± 0.73, P < 0.001; 4 wk: 2.12 ± 1.26 vs 4.12 ± 0.73, P < 0.001; 8 wk: 1.79 ± 1.09 vs 4.24 ± 0.77, P < 0.001; 12 wk: 0.69 ± 0.92 vs 4.25 ± 0.70, P < 0.001). Twenty-five of the 45 patients had complete resolution of vomiting during the observation period (mean time to resolution was 37.9 ± 27.3 d). The postprandial fullness and early satiety subscale, bloating subscale and total GCSI scores were also improved. Finally, the blood glucose levels improved after treatment, although the change was not significant.

CONCLUSION: Use of the combination of symptoms, syndrome and disease to treat diabetic gastroparesis with refractory nausea and vomiting may be a new treatment option.

• Diabetic gastroparesis
• Refractory nausea and vomiting
• Traditional Chinese medicine
• Treatment
• Gastroparesis Cardinal Symptom Index

• Adult
• Aged
• Aged, 80 and over
• Antiemetics/therapeutic use
• Biomarkers/blood
• Blood Glucose/drug effects
• Blood Glucose/metabolism
• China
• Diabetes Complications/blood
• Diabetes Complications/diagnosis
• Diabetes Complications/drug therapy
• Diabetes Complications/etiology
• Drugs, Chinese Herbal/therapeutic use
• Female
• Gastroparesis/blood
• Gastroparesis/diagnosis
• Gastroparesis/drug therapy
• Gastroparesis/etiology
• Humans
• Hypoglycemic Agents/therapeutic use
• Male
• Medicine, Chinese Traditional
• Middle Aged
• Nausea/drug therapy
• Nausea/etiology
• Retrospective Studies
• Severity of Illness Index
• Time Factors
• Treatment Outcome
• Vomiting/drug therapy
• Vomiting/etiology

• acylated ghrelin
• des-acyl ghrelin
• dysmotility
• gastric emptying
• restraint stress
• rikkunshito

• brain
• brain-gut interaction
• fMRI
• functional dyspepsia
• resting state

• cognitive modulation
• conditioned pain modulation
• diffuse noxious inhibitory controls
• distraction
• endogenous pain modulation
• functional dyspepsia
• functional gastrointestinal disorders
• pain facilitation
• pain inhibition
• visceral pain

• Complementary and alternative medicine
• Functional dyspepsia
• Hyang-Sa-Pyeong-Wi-San
• Quality of Life

• Adult
• Aged
• Double-Blind Method
• Dyspepsia/drug therapy
• Female
• Humans
• Male
• Medicine, East Asian Traditional
• Middle Aged
• Phytotherapy
• Plant Preparations/therapeutic use
• Quality of Life
• Young Adult

• acute stress
• dyspepsia
• gastric accommodation
• gastric emptying

• Adult
• Anxiety/physiopathology
• Brain/physiopathology
• Brain Mapping/methods
• Case-Control Studies
• Dyspepsia/physiopathology
• Dyspepsia/psychology
• Female
• Humans
• Male
• Young Adult

Background. Chinese herbal medicine (CHM) has been used in China and elsewhere to treat patients with functional dyspepsia (FD). However, controlled studies supporting the efficacy of such treatment are lacking. Objective. To assess the efficacy and safety of modified Ban xia xie xin decoction in patients with FD of cold and heat in complexity syndrome. Methods. We performed a randomized, double-blind, placebo-controlled trial involving patients from five centers. Patients with FD of cold and heat in complexity syndrome (n = 101) were randomly assigned to groups given either CHM modified Ban Xia Xie Xin decoction or placebo in a 2 : 1 ratio. Herbal or placebo granules were dissolved in 300 mL of boiled water cooled to 70°C. Patients in both groups were administered 150 mL (50°C) twice daily. The trial included a 4-week treatment period and a 4-week followup period. The primary outcomes were dyspepsia symptom scores, measured by the total dyspepsia symptom scale and the single dyspepsia symptom scale at weeks 0, 1, 2, 3, 4, and 8. Results. Compared with patients in the placebo group, patients in the CHM group showed significant improvements according to the total and single dyspepsia symptom scores obtained from patients (P < 0.01) and investigators (P < 0.01). Conclusions. CHM modified Ban Xia Xie Xin decoction appears to offer symptomatic improvement in patients with FD of cold and heat in complexity syndrome. Trial Registration. Chinese Clinical Trial Registry (ChiCTR): ChiCTR-TRC-10001074.

There have been few studies on the efficacy of proton pump inhibitors and the doses required to treat dyspeptic symptoms observed in clinical practice. The aim of this study was to compare the efficacy of different doses of omeprazole and different administration methods in Helicobacter pylori-negative, dyspeptic patients.

Patients with chronic upper abdominal symptoms within the previous 3 months were randomly divided into three groups: a daily, omeprazole 20 mg treatment group (OPZ20, n=61); a daily, omeprazole 10 mg treatment group (OPZ10, n=72); and an on-demand omeprazole 20 mg treatment group (on-demand, n=62). After 4 weeks of administration of the drug, symptom improvement rates were evaluated based on the Overall Global Severity score.

The rates of symptom improvement after 4 weeks of treatment were 65.6% (40/61) in the OPZ20 group, 47.2% (34/72) in the OPZ10 group, and 50.0% (31/62) in the on-demand group. The OPZ20 group exhibited a significantly higher improvement rate (p=0.034) than the OPZ10 group. The OPZ20 group had significant improvements in regurgitation, postprandial fullness, vomiting, and bloating compared with the OPZ10 group.

Daily treatment with 20 mg of omeprazole was efficient in treating upper abdominal symptoms. Trial registration: ClinicalTrials.gov, number UMIN000002621.

• Dyspepsia
• Omeprazole
• Primary health care
• Proton pump inhibitors

• adaptation
• aspirin
• placebo
• rebamipide
• symptoms

Gastrointestinal symptoms are a problematic issue for patients who take low-dose aspirin for long time. We conducted a pilot study to investigate the efficacy of combination therapy with proton pump inhibitor and rebamipide. This was a prospective, randomized, double-blind, placebo-controlled cross-over study. All the subjects received aspirin 100 mg and omeprazole 20 mg. The subjects were divided into two groups and received either rebamipide 300 mg or placebo, which was prescribed for 4 weeks. The subjects were instructed to record their gastrointestinal symptom rating scale before the study and 1 and 4 weeks after beginning the protocol. These scores of the groups were compared before and after the treatment to evaluate the severity of their symptoms and the number of symptom items present in each group. For the subjects receiving rebamipide, the total prevalence of lower gastrointestinal symptoms was significantly different from the placebo group (p=0.0093) at week 4. No troublesome symptoms were observed in the rebamipide group. Inconclusion, the administration of rebamipide prevented the occurrence of troublesome symptoms, especially lower gastrointestinal symptoms, in patients taking aspirin and omeprazole. Rebamipide is a candidate drug for combination therapy with proton pump inhibitors to prevent low-dose aspirin-induced gastrointestinal symptoms.

• adaptation
• aspirin
• placebo
• rebamipide
• symptoms

The diagnosis of functional dyspepsia (FD) is challenging since it depends largely on symptoms which are often heterogeneous and overlapping. This is particularly so in Asia with many different cultures and languages. Symptom-based diagnosis of FD based on Rome III criteria has not been fully validated and it may not be suitable in some Asian populations. Clinicians often assume that investigations in FD are not rewarding and physiological tests are often not available unless in the research setting. Investigation of alarm features and role of Helicobacter pylori in FD remain controversial but experts agreed that both should be tested. Physiological tests including gastric accommodation and chemical hypersensitivity tests are underutilized in Asia and available studies were few. While experts do not recommend routine clinical use of gastric accommodation tests but they agree that these tests can be advocated if clinically indicated. Empiric therapeutic trial is not currently a diagnostic option. The pathogenesis of FD is still poorly understood and there is a substantial placebo response. As a conclusion, a diagnosis of FD is challenging especially so in the context of Asia and despite the limitations of available physiological tests experts agreed that these tests can be advocated if and when clinically indicated.

• Asia
• Functional dyspepsia
• Helicobacter pylori

• dorsal motor nucleus of the vagus
• nucleus of the solitary tract
• stomach
• tyrosine hydroxylase
• ultrastructure
• immunoreactivity

• GI symptoms
• bezoar
• delayed gastric emptying
• diabetes mellitus
• diabetic gastroparesis
• glycemic control

Drug treatment of functional dyspepsia is often unsatisfactory. We assessed the efficacy of a bicarbonate-sulphate-calcium thermal water cycle of 12 days, in patients with functional dyspepsia. Patients with functional dyspepsia were sent by their general practitioners to 12 days of treatment with thermal water, 200–400 ml in the morning, at temperature of 33°C (91.4 F) and were evaluated on a strict intention to treat basis. Four efficacy endpoints were analyzed as follows: (i) reduction of the global symptoms score, (ii) reduction of intensity to a level not interfering with everyday activities, (iii) specific efficacy on ulcer-like or dysmotility-like dyspepsia and (iv) esophageal or abdominal-associated symptoms. Statistical significance was reached for all three primary outcomes after the first 29 consecutive patients. Thermal water reduced the global symptom score, reduced intensity of symptoms to a level not interfering with everyday activity, but was unable to completely suppress all symptoms. A parallel effect emerged for ulcer-like and dyspepsia-like subgroups. The effect on heartburn and abdominal symptoms was not significant, suggesting a specific effect of the water on the gastric and duodenal wall. The Roma II criteria identify a natural kind of dyspepsia that improves with thermal water. Ulcer-like and dysmotility-like are not therapeutically distinguishable subgroups. Patients with dominant esophageal or abdominal symptoms should receive a different therapy. Sequential methods are very effective for the evaluation of traditional care practices and should be considered preliminary and integrative to randomized controlled trials in this context.

• balneotherapy
• functional dyspepsia
• functional gastrointestinal disorders
• hydrotherapy
• sequential methods
• spa
• thermal care