title: Therapeutic efficacy of acotiamide in patients with functional dyspepsia based on enhanced postprandial gastric accommodation and emptying: randomized controlled study evaluation by real-time ultrasonography.
abstract: BACKGROUND
  Improvement in subjective symptoms has been reported in functional dyspepsia (FD) patients administered with acotiamide. Improvement was confirmed in meal-related symptoms, such as postprandial fullness, upper abdominal bloating, and early satiety. We examined the mechanism underlying the effects of acotiamide on gastric accommodation reflex (GAR) and gastroduodenal motility in FD patients.
  
  
  METHODS
  Thirty-four FD patients (mean age, 40.4 years) were examined ultrasonographically before and after 14-18 days of acotiamide (100 mg t.i.d.) or placebo administration. To assess GAR, expansion rate in cross-sectional area of the proximal stomach was measured after every 100-mL ingestion, using a straw, of up to 400 mL of a liquid meal (consommé soup, 13.1 kcal; 400 mL) in a supine position. Next, we measured gastric emptying rate (GER), motility index (MI, antral contractions), and reflux index (RI, duodenogastric reflux) to assess gastroduodenal motility. Patients also completed a survey based on the seven-point Likert scale both before and after drug administration.
  
  
  RESULTS
  Of the 37 cases, 19 and 18 were administered with acotiamide and placebo A respectively, significant difference was observed in GAR between the acotiamide and placebo groups (21.7%vs 4.4%) after 400 mL ingestion. GER significantly accelerated after treatment in the acotiamide group (P = 0.012), no significant differences were observed in MI and RI between the two groups. Improvement rates were 35.3 and 11.8% for the acotiamide and placebo groups.
  
  
  CONCLUSIONS
  Acotiamide significantly enhances GAR and GER in FD patients. Acotiamide may have therapeutic potential for FD patients.
authors.affiliation: Department of General Medicine, Kawasaki Medical School, Kurashiki, Japan. kusunoki@med.kawasaki-m.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Kusunoki
authors.forename: K
authors.initials: K
authors.lastname: Haruma
authors.forename: N
authors.initials: N
authors.lastname: Manabe
authors.forename: H
authors.initials: H
authors.lastname: Imamura
authors.forename: T
authors.initials: T
authors.lastname: Kamada
authors.forename: A
authors.initials: A
authors.lastname: Shiotani
authors.forename: J
authors.initials: J
authors.lastname: Hata
authors.forename: H
authors.initials: H
authors.lastname: Sugioka
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
authors.forename: H
authors.initials: H
authors.lastname: Kato
authors.forename: J
authors.initials: J
authors.lastname: Tack
mesh_terms: D000328:Adult; D000368:Aged; D001549:Benzamides / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period / Q000187:drug effects*; D013270:Stomach / Q000000981:diagnostic imaging / Q000187:drug effects*; D016683:Supine Position; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D001549:Benzamides; D013844:Thiazoles; C410959:Z 338