A Prospective study on the Management of Functional Dyspepsia

BACKGROUND: Functional dyspepsia (FD) is defined by as the presence of symptoms thought to originate from the gastroduodenal region. According to Rome III criteria the main symptoms of functional dyspepsia include postprandial fullness, early satiation, epigastralgia and epigastric burning. In spite of several therapeutic options for the treatment of FD, It can be still confusing to healthcare providers because there is no definite treatment for functional dyspepsia. It is necessary to identify the better therapeutic options for functional dyspepsia. This study assessed the therapeutic outcome and quality of life of patients with functional dyspepsia by treating with proton pump inhibitor, domperidone and acotiamide, and also the efficacy of acotiamide against the other therapeutic options. METHOD: It was a prospective study conducted on KMCH Hospital, Coimbatore in which a total 60 patients, were divided into three groups. Patients were divided into three groups.(GroupI-Acotiamide+PPI, Group II-Domperidone+PPI, Group III-PPI). Patients details were collected from data collection form and symptom analysis carried out using Visual Analogue Scale.Quality of life of patients was assessed by using Nepean Dyspepsia Index (SF-NDI) questionnaire. The paired student ‘t’ test was conducted to analyze the difference in score after each group of treatment and also to assess the efficacy of acotiamide were studies using SPSSv20.0. RESULTS: By this study it was found that the overall symptom score was reduced in acotiamide and domperidone therapy. (p < 0.001 and p = 0.042). While in PPI the overall symptom was not significantly reduced. Overall SF-NDI score showed a significant greater improvement from baseline (p = 0.000), Similarly all the five SF-NDI subscale scores showed improvement than other two groups. There is significant improvement in the abdominal bloating, postprandial fullness, abdominal pain, excessive belching, heart burn, upper abdominal discomfort. CONCLUSION: Cases with functional dyspepsia have characteristics of middle age, male predominance, Non vegetarian food consumers are more prone to develop FD. From this study it was concluded that acotiamide has better efficacy than PPI monotherapy and combination of PPI and domperidone therapy.