Proton pump inhibitors for functional dyspepsia.

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Trials

Background:

• Functional dyspepsia (FD) involves persistent upper abdominal discomfort without an identified organic cause.
• Proton pump inhibitors (PPIs) are used for FD, but their effectiveness is debated.
• Long-term PPI use carries potential adverse events, necessitating careful indication assessment.

Purpose of the Study:

• To systematically review the efficacy of PPIs in alleviating FD symptoms.
• To compare PPIs against placebo, H2 receptor antagonists (H2RAs), and prokinetics for FD symptom improvement and quality of life.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) meeting specific inclusion criteria.
• Searched multiple electronic databases and trial registries up to May 2017.
• Included adult participants with diagnosed FD, comparing PPIs to placebo, H2RAs, or prokinetics for at least two weeks.

Main Results:

• PPIs demonstrated greater efficacy than placebo in improving overall FD symptoms (moderate quality evidence).
• PPIs showed similar efficacy to H2RAs (low quality evidence) and potentially slight superiority over prokinetics (low quality evidence).
• No significant differences in adverse events were noted between PPIs and other treatments, except for fewer events with PPIs plus prokinetics versus prokinetics alone.

Conclusions:

• PPIs are effective for treating FD symptoms, regardless of dose or duration, when compared to placebo.
• PPIs may offer a slight advantage over prokinetics, though supporting evidence is limited and trials have bias risks.
• Despite a potentially small effect, PPIs are generally well-tolerated for FD management.