title: Nizatidine improves clinical symptoms and gastric emptying in patients with functional dyspepsia accompanied by impaired gastric emptying.
abstract: OBJECTIVE
  In this crossover study, we investigated whether nizatidine, a H(2)-receptor antagonist, can alleviate clinical symptoms and gastric emptying in patients with Rome III-based functional dyspepsia (FD) with or without impaired gastric emptying.
  
  
  METHODS
  We enrolled 30 patients presenting with FD symptoms (epigastric pain syndrome, n = 6; postprandial distress syndrome, n = 24). Rome III-based FD patients were treated with nizatidine (300 mg/day) or placebo for 4 weeks in a crossover trial. Gastric motility was mainly evaluated with the T(max) value using the (13)C-acetate breath test. Meal-related symptoms were defined as postprandial fullness and early satiation. Gastroesophageal symptom was defined as a burning feeling rising from the stomach or lower chest up toward the neck. Acylated- and desacylated ghrelin levels were evaluated by the ELISA method. Clinical symptoms, gastric emptying and ghrelin levels were evaluated at three different points during the study (pretreatment, after 4 weeks former treatment and after 4 weeks later treatment). The primary end point of this study was to determine whether nizatidine would improve clinical symptoms and gastric emptying in FD patients with or without impaired gastric emptying via affecting ghrelin levels.
  
  
  RESULTS
  Meal-related symptoms of the patients treated with nizatidine improved significantly (21/30; 70%) compared to those treated with placebo (3/30; 10%). In addition, nizatidine treatment also significantly improved gastroesophageal symptoms (16/30; 53%) compared to those treated with placebo (0/30; 0%). Nizatidine treatment in patients with FD accompanied by impaired gastric emptying significantly improved clinical symptoms and T(max) value as a marker of gastric emptying (10/11, 91%; 9/11, 82%) compared to placebo therapy, respectively. There were no significant differences in ghrelin levels between nizatidine treatment and placebo therapy.
  
  
  CONCLUSIONS
  Nizatidine administration significantly improved both gastric emptying and clinical symptoms in FD patients with impaired gastric emptying.
authors: Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. seiji.futagami@gmail.com
authors: S
authors: S
authors: Futagami
authors: M
authors: M
authors: Shimpuku
authors: J M
authors: JM
authors: Song
authors: Y
authors: Y
authors: Kodaka
authors: H
authors: H
authors: Yamawaki
authors: H
authors: H
authors: Nagoya
authors: T
authors: T
authors: Shindo
authors: T
authors: T
authors: Kawagoe
authors: A
authors: A
authors: Horie
authors: K
authors: K
authors: Gudis
authors: K
authors: K
authors: Iwakiri
authors: C
authors: C
authors: Sakamoto
mesh_terms: D000085:Acetates / Q000032:analysis; D000328:Adult; D000368:Aged; D001944:Breath Tests; D002247:Carbon Isotopes; D018592:Cross-Over Studies; D004415:Dyspepsia / Q000188:drug therapy*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D054439:Ghrelin / Q000097:blood / Q000187:drug effects; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016567:Nizatidine / Q000627:therapeutic use*; D019518:Postprandial Period / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000085:Acetates; D002247:Carbon Isotopes; D054439:Ghrelin; D006635:Histamine H2 Antagonists; D016567:Nizatidine