Epidemiology of symoptoms and multifactorial analysis of the efficiency of cisapride on functional dyspepsia

Abstract

AIM: Functional dyspepsia is considered to be a group of chronic or recurring upper gastrointestinal symptoms. Although the concept of dyspepsia has been accepted by more and more doctors, there are different opinions of it. Moreover, the treatment of functional dyspepsia is still a challenge for the clinicians. In China 500 hospitals in 20 provinces or cities undertook a multicentre study to evaluate the epideminology of the symptoms of functional dyspepsia and to investigate the efficacy of cisapride.

METHODS: The study consisted of 8896 cases, including 4370 men and 4526 women, with a mean age of 42.3 years and a mean history of 16.5 mo (range 1-94). All patients consulted doctor because of one or more of the eight symptoms of epigastric distention, postprandial fullness, belching, early satiety, epigastric pain, poor appetite, nausea, and vomiting. Routine laboratory examination, ultrasonography, upper gastrointestinal endoscopy or GI showed no abnormalities. The severity and history of all the eight symptoms were carefully asked to evaluate the differences among the districts. Multifactorial analysis was used to study the relationship between the severity of the symptoms and sex, age, and history of the patients. Cisapride was given 5 mg three times daily. The efficacy was studied in 2 wk and 4 wk.

RESULTS: Epigastric distention was the most frequency chief complaint (89.7%), followed by postprandial fullness (87.7%), belching (74.7%), early satiety (63.2%), epigastric pain (57.8%), poor appetite (52.8%) and nausea (50.8%). Furthermore there were considerable overlap among these symptoms. The seriousness of the symptom correlated with the history. The longer the history, the more severe the symptoms (P < 0.01). Cisapride significantly reduced the severity of all symptoms after 2 wk of treatment, and the effect was more pronounced after 4 wk (P < 0.01). The more severe and longer history of the symptoms, the better efficacy of cisapride (P < 0.01). During the trial, had 1743 cases (19.6%) side effects, including loose stool (16.1%), increased peristaltic sound (12.9%), and transit spastic abdominal pain (5.2%). All these side effects were mild and needed no medical care.

CONCLUSION: The seven symptoms mentioned above were the most frequent chief complaints of Chinese functional dyspepsia patients. Cisapride was effective in the treatment of functional dyspepsia.

Key Words: Epidemiology; Multifactorial analysis; Cisapride; Functional dyspepsia