The challenge of managing functional dyspepsia and emerging role of simethicone- based triple drug therapy (rabeprazole + domperidone + simethicone): A real world expert opinion questionnaire based study

Résumé fourni par la source

Background: Patients with functional abdominal bloating and distension disorders are commonly treated with empirical acid-suppressive therapy with proton pump inhibitors (PPIs), and prokinetic drugs.However, a subset of patients do not get adequate relief of symptoms of bloating. In functional gastrointestinal disorders, simethicone reduces the symptoms of bloating. Objective: To assess the efficacy of the triple drug combination of rabeprazole + domperidone + simethicone in patients with functional abdominal bloating and distension (FABD) in the real world setting in India. Methodology: 267 expert physicians treating functional dyspepsia were invited to participate in the study. The experts answered the structured web based questionnaire. Results: 86.1% Indian physicians opined that functional dyspepsia was most common in the age group of 30 to 60 years. The most common comorbid disorders were GERD (76.7%), diabetes mellitus (52.06%). hypertension (40.45%), and irritable bowel syndrome(38.9%), 51% participants reported that their patients had been treated earlier with proton pump inhibitors alone while 40.45% participants had treated their patients earlier with PPI + Prokinetic drug. 55% respondents preferred simethicone in patients with moderate severity of bloating and heart burn (46%), epigastric pain (38.5%), and post-meal heaviness (43.07%). Respondents opined that simethicone based formulations are effective across the spectrum of symptom severity ranging from mild to very severe. Conclusion: Bloating, heartburn, epigastric pain and post meal fullness are commonly reported in patients with functional dyspepsia. The addition of simethicone to rabeprazole and domperidone improves symptom, regardless of the severity of symptoms of bloating, epigastric pain, heart burn and post meal heaviness.