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Frontiers in Pharmacology 2023Although (XYS) is a popular herbal remedy for indigestion, there is insufficient evidence to recommend it as a treatment option for functional dyspepsia (FD). This...
Although (XYS) is a popular herbal remedy for indigestion, there is insufficient evidence to recommend it as a treatment option for functional dyspepsia (FD). This review aimed to assess the safety and efficacy of XYS in patients with FD, compared to conventional Western medicine (WM). Two independent reviewers searched for randomized controlled trials (RCTs) using 11 electronic databases, including Medline and Embase, to evaluate therapeutic effects of XYS on FD up to 31 January 2023. The primary outcome was the total clinical efficacy rate (TCE), and secondary outcomes included scores of dyspepsia-related symptoms (DSS) and incidence of adverse events (AEs). The risk of bias was evaluated using the Cochrane collaboration tool, and data synthesis and subgroup analyses were performed using the Review Manager program. Six studies involving 707 participants were included in the meta-analysis. XYS significantly improved TCE compared to WM (RR = 1.15, 95% CI: 1.05, 1.26, = 0.002) with high heterogeneity ( = 59%, = 0.06). Combination therapy also showed higher TCE than WM alone (RR = 1.22, 95% CI: 1.05, 1.41, = 0.008), and the heterogeneity was low ( = 0%, = 0.86). The results showed a greater reduction in DSS in the XYS and combination therapy groups than in the WM alone group (SMD = -0.72, 95% CI: -0.90, -0.53, < 0.00001) with low heterogeneity ( = 44%, = 0.15), especially for abdominal distension and upper abdominal pain. AEs occurred less frequently in the XYS and combination therapy groups than in the WM alone group (RR = 0.20, 95% CI: 0.07, 0.63, = 0.006), and the heterogeneity was low ( = 45%, = 0.18). The certainty of the evidence for each outcome was rated from "very low" to "high." This review suggests that XYS is effective and safe for reducing complaints in patients with FD. However, high-quality RCTs should be conducted to establish more convincing therapeutic evidence of XYS for the treatment of FD. https://www.crd.york.ac.uk/prospero, CRD42020178842.
PubMed: 37124216
DOI: 10.3389/fphar.2023.1114222 -
World Journal of Gastroenterology Jun 2021Eating disorders (ED) involve both the nervous system and the gastrointestinal tract. A similar double involvement is also found in disorders of the brain-gut...
BACKGROUND
Eating disorders (ED) involve both the nervous system and the gastrointestinal tract. A similar double involvement is also found in disorders of the brain-gut interaction (DGBI) and symptoms are sometimes similar.
AIM
To find out where there is an association and a cause-effect relationship, we looked for the comorbidity of DGBI and ED.
METHODS
A systematic review was undertaken. A literature search was performed. Inclusion criteria for the articles retained for analysis were: Observational cohort population-based or hospital-based and case-control studies, examining the relationship between DGBI and ED. Exclusion criteria were: Studies written in other languages than English, abstracts, conference presentations, letters to the Editor and editorials. Selected papers by two independent investigators were critically evaluated and included in this review.
RESULTS
We found 29 articles analyzing the relation between DGBI and ED comprising 13 articles on gastroparesis, 5 articles on functional dyspepsia, 7 articles about functional constipation and 4 articles on irritable bowel syndrome.
CONCLUSION
There is no evidence for a cause-effect relationship between DGBI and ED. Their common symptomatology requires correct identification and a tailored therapy of each disorder.
Topics: Brain; Constipation; Dyspepsia; Feeding and Eating Disorders; Humans; Irritable Bowel Syndrome
PubMed: 34239277
DOI: 10.3748/wjg.v27.i24.3668 -
Frontiers in Public Health 2022There has been a significant increase in the number of systematic reviews (SRs)/meta-analyses (MAs) investigating the effects of acupuncture for functional dyspepsia...
BACKGROUND AND AIMS
There has been a significant increase in the number of systematic reviews (SRs)/meta-analyses (MAs) investigating the effects of acupuncture for functional dyspepsia (FD). To systematically collate, appraise, and synthesize the current evidence, we carried out an umbrella review of SRs/MAs.
METHODS
Systemic reviews/meta-analyses on acupuncture for FD were collected by searching major medical databases. The included studies were evaluated in terms of methodological quality, reporting quality, and evidence quality using the criteria from the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system, respectively.
RESULTS
Ten SRs/MAs were analyzed for this study. The methodological quality, reporting quality, and evidence quality of the included SRs/MAs were generally unsatisfactory. Lack of protocol registration, no list of excluded trials, or lack of a comprehensive search strategy were the main limitations. No high-quality evidence was found to support the effects of acupuncture for FD; the qualitative data synthesis relied on low quality trials with small sample sizes and was the main factor for evidence degradation.
CONCLUSIONS
Acupuncture seems to have a promising efficacy in the treatment of FD. It provides a new and prospective therapeutic method for FD. Although the quality of the included SRs/MAs was generally low and defects were frequent, this umbrella review highlights areas where improvement in methodology is required.
Topics: Acupuncture Therapy; Databases, Factual; Dyspepsia; Humans; Reproducibility of Results; Research Report
PubMed: 35433619
DOI: 10.3389/fpubh.2022.842096 -
Integrative Medicine Research Sep 2021in Traditional Chinese Medicine (TCM) has been recognised by the eleventh revision of the International Classification of Diseases (ICD-11). Accurate pattern diagnosis... (Review)
Review
BACKGROUND
in Traditional Chinese Medicine (TCM) has been recognised by the eleventh revision of the International Classification of Diseases (ICD-11). Accurate pattern diagnosis requires reliable and valid diagnostic instruments that guide the collection of TCM clinical data without bias. This study synthesised the existing TCM diagnostic instruments for functional dyspepsia (FD) and appraised their quality regarding their development process and measurement properties.
METHODS
Seven electronic databases were searched for validation studies on TCM diagnostic instruments for FD. Synthesis and appraisal of the included studies were performed following the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) Initiative guidelines adapted for TCM diagnostic instruments. Risk of bias assessment was conducted using the .
RESULTS
Five studies were included, with five unique TCM diagnostic instruments for FD identified. All five diagnostic instruments were of inadequate quality in terms of their development process, implying a shortcoming in their relevance, comprehensibility, and comprehensiveness. Only the criterion validity of was of sufficient quality and had no risk of bias in its validation.
CONCLUSION
The quality of TCM diagnostic instruments for FD warrants urgent improvements. None of them was considered reliable or valid for guiding TCM pattern diagnosis. To support the evidence base of the standardization of TCM patterns in ICD-11, TCM diagnostic instruments should be developed and validated rigorously under the COSMIN guidelines. Amendments should be made on the guidelines to accommodate the features and uniqueness of TCM diagnostic process.
PubMed: 33665098
DOI: 10.1016/j.imr.2020.100713 -
Journal of Gastroenterology and... Nov 2021The therapeutic effect of acupuncture treatments (AT) on functional gastrointestinal disorders (FGIDs) is contentious. A meta-analysis was conducted to assess the... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The therapeutic effect of acupuncture treatments (AT) on functional gastrointestinal disorders (FGIDs) is contentious. A meta-analysis was conducted to assess the efficacy and safety of acupuncture for FGIDs.
METHODS
The Cochrane Library, EMBASE, PUBMED, Web of Science, Wanfang Database, China National Knowledge Infrastructure, and VIP Database were searched through December 31, 2019 with no language restrictions. Risk ratio (RR) with 95% confidence interval (CI) was calculated to determine the improvement in symptom severity after treatment.
RESULTS
A total of 61 randomized controlled trials (RCTs) on FGIDs were included. The pooled results illustrated the following: compared to pharmacotherapy (RR 1.13, 95% CI 1.09-1.17), placebo acupuncture (RR 1.69, 95% CI 1.37-2.08), no specific treatment (RR 1.86, 95% CI 1.31-2.62), and AT as an adjuvant intervention to other active treatments (RR 1.25, 95% CI 1.21-1.30), AT had more favorable improvements in symptom severity; sub-group analysis results classified according to functional dyspepsia, irritable bowel syndrome, and functional constipation also supported this finding; and the incidence of adverse events was lower in AT than in other treatments (RR 0.75, 95% CI 0.56-0.99).
CONCLUSIONS
This meta-analysis found that AT was significantly associated with relief of FGIDs symptoms; however, the evidence level was moderate or low. Further data from rigorously designed and well powered RCTs are needed to verify the effectiveness and safety of AT as a FGIDs treatment.
PROSPERO PROTOCOL NUMBER
CRD42020169508.
Topics: Acupuncture Therapy; Constipation; Dyspepsia; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Randomized Controlled Trials as Topic
PubMed: 34342044
DOI: 10.1111/jgh.15645 -
Integrative Medicine Research Jun 2021Dyspepsia represents a symptom domain rather than a diagnostic condition and covers a wide range of complex, underlying pathophysiologies that are not well understood.... (Review)
Review
BACKGROUND
Dyspepsia represents a symptom domain rather than a diagnostic condition and covers a wide range of complex, underlying pathophysiologies that are not well understood. The review explores comparative effectiveness interventions for the treatment of symptomatic dyspepsia along a pragmatic-explanatory continuum. The aim is to identify relevant design characteristics applicable to future upper gastrointestinal comparative effectiveness research employing integrative medicine.
METHODS
Medline, CINAHL, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and WHO Clinical Trials were systematically searched until January 2019. Included articles were original research with two or more comparative intervention arms for the primary outcome; relief of symptomatic dyspepsia. Evaluation of the studies was conducted using the pragmatic-explanatory continuum indicator summary (PRECIS-2) tool.
RESULTS
Thirty-six articles were included in the review. A total of 68 Patient Reported Outcome Measurements (PROMs), utilizing 50 different formats were deployed across the studies. The appraisal process revealed eligibility, flexibility in adherence, flexibility in delivery and organization domains further aligned towards an explanatory design.
CONCLUSION
This review identified three design characteristics relevant for future comparative effectiveness research for the treatment of upper gastrointestinal disorders in a community setting. Extensive exclusion eligibility criteria limited the generalization of comparative effectiveness study results by removing sub-groups of the target populations more at risk of dyspeptic symptoms. The requirement for entry endoscopy was found to be common and not always pragmatically justifiable. Development of validated PROMs appropriate for a generic application to upper gastrointestinal disorders would be advantageous for future comparative effectiveness research within integrative medicine.
PubMed: 34258220
DOI: 10.1016/j.imr.2020.100663 -
Evidence-based Complementary and... 2019A combination of peppermint oil and caraway oil (POCO) with its unique properties has been shown clinical benefits for FD. However, the potent statistical data to... (Review)
Review
A combination of peppermint oil and caraway oil (POCO) with its unique properties has been shown clinical benefits for FD. However, the potent statistical data to confirm its effects are lacking. This meta-analysis thus aimed at evaluating the efficacy and safety of POCO compared with placebo in treating patients with FD. We searched CENTRAL, PubMed, EMBASE (Ovid), Web of Science, Google Scholar, China National Knowledge Infrastructure database, Wanfang, and VIP databases for randomized clinical trials (RCTs) up to June 2019. Dichotomous data were shown as a risk ratio (RR) with 95% confidence intervals (CIs). All data were analyzed by Review Manager 5.2 software. The search identified 382 citations, and 5 RCTs (578 participants) were included. POCO showed a statistically significant effect in global improvement of FD symptoms (RR for not much or very much improvement 0.59, 95% CI: 0.49 to 0.71, < 0.00001, 36%, NNT 3) and improvement in epigastric pain (RR 1.61, 95% CI: 1.28 to 2.03, < 0.0001, 0%, NNT 3). There were no significant differences in the total number of adverse events between POCO and placebo (NNH 40). In conclusion, this is the first meta-analysis to assess the effects of POCO in FD. POCO is an effective and safe short-term treatment for FD. However, current findings are based on smaller sample sizes and low/very low quality of the evidence. More well-designed RCTs with large sample sizes of FD patients are required.
PubMed: 31827561
DOI: 10.1155/2019/7654947 -
Journal of Dentistry Aug 2022To give an overview of the current evidence on the associations of general health conditions with masticatory performance and maximum bite force in older adults. (Review)
Review
OBJECTIVES
To give an overview of the current evidence on the associations of general health conditions with masticatory performance and maximum bite force in older adults.
DATA/SOURCES
Three electronic databases (Medline via PubMed, Embase via Ovid and CINAHL Plus via EBSCOhost) were searched up to September 2021 for cross-sectional studies on general health conditions and masticatory performance or maximum bite force in older adults. Methodological quality of the included studies was independently evaluated based on Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between general health conditions and masticatory performance or maximum bite force were extracted.
STUDY SELECTION
Of the 5133 records identified, 39 studies (43 articles) were included in this review. Significant negative associations were found between masticatory performance and stroke, sarcopenia, amyotrophic lateral sclerosis, chronic obstructive pulmonary disease, dyspepsia, dysphagia, anorexia, and carotid atherosclerosis. Significant negative association was found between maximum bite force and sarcopenia. There were equivocal results on the association between masticatory performance and diabetes mellitus, and between maximum bite force and stroke, and amyotrophic lateral sclerosis. There was no significant association between masticatory performance and metabolic syndrome, and between maximum bite force and progress of Parkinson's disease. Most studies revealed positive associations of physical function with masticatory performance and maximum bite force.
CONCLUSIONS
Negative associations between masticatory function of older adults and presence of several systemic diseases have been reported in a number of studies while there are positive associations between masticatory function and some physical function indicators.
CLINICAL SIGNIFICANCE
This study provides valuable information on the association of masticatory function with general health, which draws clinicians' attention to the masticatory function of older adults who suffer from certain systemic diseases or physical dysfunction, and to the need to improve their masticatory ability to achieve healthy aging.
Topics: Aged; Amyotrophic Lateral Sclerosis; Bite Force; Cross-Sectional Studies; Humans; Mastication; Sarcopenia; Stroke
PubMed: 35691453
DOI: 10.1016/j.jdent.2022.104186 -
Journal of Psychosomatic Research Aug 2024To determine the prevalence and associations between anxiety/depression, and gastrointestinal (GI) symptoms across gastroparesis and functional dyspepsia. (Meta-Analysis)
Meta-Analysis Comparative Study
Comparing the prevalence and association between anxiety, depression and gastrointestinal symptoms in gastroparesis versus functional dyspepsia: A systematic review and meta-analysis.
OBJECTIVE
To determine the prevalence and associations between anxiety/depression, and gastrointestinal (GI) symptoms across gastroparesis and functional dyspepsia.
METHODS
Twenty adult studies were identified through systematic searches of three databases (PubMed, CINAHL and PsycINFO) in September 2023. Meta-analysis was performed to estimate the pooled prevalence rates of anxiety and depression across gastroparesis and functional dyspepsia, and to determine whether the associations of anxiety/depression and gastrointestinal (GI) symptoms differ in gastroparesis versus functional dyspepsia.
RESULTS
The overall pooled prevalence rate for anxiety was similar (χ(1) = 2.45, p = .12) in gastroparesis (49%) and functional dyspepsia (29%). The overall pooled prevalence rate for depression in gastroparesis (39%), and functional dyspepsia (32%) was also similar (χ(1) = 0.81, p = .37). No significant relationship between anxiety and GI symptoms (r = 0.11) or depression and GI symptoms (r = 0.16) was found in gastroparesis, whilst significant, though weak, positive relationships between anxiety and GI symptoms (r = 0.30) and depression and GI symptoms (r = 0.32) were found in functional dyspepsia. The association between GI symptoms and anxiety, but not depression, across gastroparesis and functional dyspepsia was found to be significant (χ(1) = 5.22, p = .02).
CONCLUSION
Contributing to ongoing debate as to whether gastroparesis and functional dyspepsia are interchangeable syndromes, this review found that anxiety and depression prevalence was similar in both conditions. Psychological assessment and the utilisation of effective and holistic care in both conditions is therefore warranted.
Topics: Humans; Gastroparesis; Dyspepsia; Prevalence; Depression; Anxiety; Gastrointestinal Diseases
PubMed: 38896986
DOI: 10.1016/j.jpsychores.2024.111834 -
Arquivos de Gastroenterologia 2022To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria.
METHODS
We included cohorts and observational descriptive studies, including information for the prevalence of FGIDs according to Rome IV criteria in children 4 to 18 years old. We searched the MEDLINE (Ovid), EMBASE, LILACS, and CENTRAL databases from May 2016 to nowadays. Gray literature and other databases were also consulted. The risk of bias was assessed using the STROBE Statement. The results were reported in forest plots of the estimated effects of the included studies with a 95% confidence interval (95%CI).
RESULTS
We included 14 studies involving a total of 17427 participants. Three studies were conducted in Europe, two in North America, and nine in Latin America. Most studies were school-based (n=14670, 84.18%), participants were mostly female (55.49%), white (51.73%), 8 to 18 years old (77.64%), and assisted to a public school (81.53%). Thirteen studies used the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS-RIV) to assess FGIDs. We found a global prevalence for FGIDs of 23% (95%CI 21-25%, I2 99%). Main disorders were functional constipation (FC) with 12% (95%CI 11-15%) followed by functional dyspepsia (FD) (5%, 95%CI 11-15%) and irritable bowel syndrome (IBS) (3%, 95%CI 2-4%). The prevalence of FGIDs was higher in the Americas, representing 23.67% (95%CI 21.2-26.2%, I2 91.3%).
CONCLUSION
FGIDs are present in one of four children and adolescents, representing a common condition in this age group the central disorders were FC, FD, and IBS.
Topics: Adolescent; Child; Child, Preschool; Constipation; Dyspepsia; Female; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Male; Prevalence; Rome; Surveys and Questionnaires
PubMed: 35830045
DOI: 10.1590/S0004-2803.202202000-53