title: Systematic review: Antacids, H2-receptor antagonists, prokinetics, bismuth and sucralfate therapy for non-ulcer dyspepsia.
abstract: BACKGROUND
  Evidence for the effectiveness of antacids, histamine-2 receptor antagonists, bismuth salts, sucralfate and prokinetic therapy in non-ulcer dyspepsia is conflicting.
  
  
  OBJECTIVE
  To conduct a systematic review evaluating these therapies in non-ulcer dyspepsia.
  
  
  METHODS
  Electronic searches were performed using the Cochrane Controlled Trials Register, Medline, EMBASE, Cinahl and SIGLE until September 2002. Dyspepsia outcomes were dichotomized into cured/improved vs. same/worse.
  
  
  RESULTS
  Prokinetics [14 trials, 1053 patients; relative risk reduction (RRR), 48%; 95% confidence interval (95% CI), 27-63%] and histamine-2 receptor antagonists (11 trials, 2164 patients; RRR, 22%; 95% CI, 7-35%) were significantly more effective than placebo. Bismuth salts (RRR, 40%; 95% CI, - 3% to 65%) were superior to placebo, but this was of marginal statistical significance. Antacids and sucralfate were not statistically significantly superior to placebo. A funnel plot suggested that the prokinetic and histamine-2 receptor antagonist results could be due to publication bias.
  
  
  CONCLUSIONS
  The meta-analyses suggest that histamine-2 receptor antagonists and prokinetics are superior to placebo. These data are difficult to interpret, however, as funnel plot asymmetry suggests that the magnitude of the effect could be due to publication bias or other heterogeneity-related issues.
authors.affiliation: Gastroenterology Unit, City Hospital NHS Trust, Birmingham, UK. p.moayyedi@bham.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Moayyedi
authors.forename: S
authors.initials: S
authors.lastname: Soo
authors.forename: J
authors.initials: J
authors.lastname: Deeks
authors.forename: D
authors.initials: D
authors.lastname: Forman
authors.forename: A
authors.initials: A
authors.lastname: Harris
authors.forename: M
authors.initials: M
authors.lastname: Innes
authors.forename: B
authors.initials: B
authors.lastname: Delaney
mesh_terms: D000284:Administration, Oral; D000863:Antacids / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D020117:Cisapride / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005772:Gastrointestinal Transit / Q000187:drug effects; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D013392:Sucralfate / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000863:Antacids; D005765:Gastrointestinal Agents; D006635:Histamine H2 Antagonists; D013392:Sucralfate; D001729:Bismuth; D020117:Cisapride