Efficacy of trimebutine therapy in patients with gastroesophageal reflux disease and irritable bowel syndrome.
OBJECTIVE
GERD (gastroesophageal reflux disease) occurs in 25-51% of IBS (irritable bowel syndrome) patients. Trimebutine has been effective in some IBS patients by modulating colonic motility. Furthermore, it increases gastric emptying rates, and controls esophageal motility. The aim of this study was to investigate the efficacy of trimebutine therapy in GERD patients with IBS.


METHODS
Sixty-nine patients with GERD and IBS underwent upper gastrointestinal endoscopic, histologic and clinical evaluation prior to and 3 months post-treatment. H. pylori presence was determined by histology and CLOtest. Forty patients (Group A) were treated with omeprazole plus trimebutine for 3 months: in 32 H. pylori-positive patients (subgroup A1), a standard triple eradication regimen was introduced. Twenty-nine patients (Group B) were treated with omeprazole for 3 months: in 24 H. pylori-positive patients (subgroup B1), the same eradication therapy was employed.


RESULTS
Specialized intestinal metaplasia of the gastroesophageal junction was observed in 20% and in 17.2% of the patients in Groups A and B, respectively. Eradication rates were similar in subgroups A1 (84%) and B1 (83%). In Group A there was a significant improvement in GERD (P = 0.003) and IBS symptoms (P < 0.0001) as well as esophagitis (P = 0.029), when compared with Group B.


CONCLUSIONS
Trimebutine appears to be effective in patients with GERD and IBS.
Kountouras
J
J
Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Greece. jannis@med.auth.gr
Chatzopoulos
D
D
Zavos
C
C
Boura
P
P
Venizelos
J
J
Kalis
A
A
D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D003109:Colonic Diseases, Functional / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D016145:Endoscopy, Digestive System; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D010276:Parasympatholytics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014287:Trimebutine / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole; D014287:Trimebutine