The comparative study of the effectiveness of cimetidine, ranitidine, famotidine, and omeprazole in treatment of children with dyspepsia

Seyed Mohsen Dehghani, Mohammad Hadi Imanieh, Roya Oboodi, Mahmood Haghighat, Seyed Mohsen Dehghani, Mohammad Hadi Imanieh, Roya Oboodi, Mahmood Haghighat

Abstract

Background. Functional dyspepsia is a common chronic disorder with non specific upper abdominal pain or discomfort. Different approaches with anti-secretory, spasmolytic, prokinetic and anti-inflammatory effects and most preferably reduction of visceral hypersensitivity seem logical. In this study, we compared the effectiveness of the four most drugs used for treatment of dyspepsia in children. Methods. 169 patients between 2 to 16 years old that 47.3% was male and 52.7% was female were enrolled in this clinical trial study by the diagnosis of functional dyspepsia. Then for each patient one of the drugs; Omeprazole, Famotidine, Ranitidine or Cimetidine was administered, for a period of 4 weeks. Patients were followed after 2 and 6 weeks from the beginning of the treatment. Results. The distribution of drugs between these patients were including; 21.9% with Cimetidine, 21.3% with Famotidine, 30.8% with Omeperazole and 26% with Ranitidine that the proportion of patients with all symptoms relief were: 21.6% for Cimetidine, 44.4% for Famotidine, 53.8% for Omeprazole and 43.2% for Cimetidine (P = .024). In followups within 2 and 6 weeks after beginning medical therapy, no side effects due to drugs were seen. Conclusion. If a cure is defined as all symptoms relief after a period of 4 weeks treatment, our findings showed that Omeperazole are superior to Ranitidine, Famotidine, and Cimetidine for management of functional dyspepsia.

References

    1. Allescher HD. Functional dyspepsia—a multicausal disease and its therapy. Phytomedicine. 2006;13(1):2–11.
    1. Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130(5):1527–1537.
    1. Soo S, Moayyedi P, Deeks J, Delaney B, Lewis M, Forman D. Psychological interventions for non-ulcer dyspepsia. Cochrane Database of Systematic Reviews. 2005 Article ID CD002301.
    1. Tack J, Broeckaert D, Coulie B, Janssens J. The influence of cisapride on gastric tone and the perception of gastric distension. Alimentary Pharmacology and Therapeutics. 1998;12(8):761–766.
    1. Lori A, Mahajan LA, Kaplan B. Chronic abdominal pain of childhood and adolescence. Pediatric Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management. (3rd edition) 2006;7:112–125.
    1. Saps M, Di Lorenzo C. Pharmacotherapy for functional gastrointestinal disorders in children. Journal of Pediatric Gastroenterology and Nutrition. 2009;48:S101–S103.
    1. Hyams JS. Chronic abdominal pain caused by sorbitol malabsorption. Journal of Pediatrics. 1982;100(5):772–773.
    1. Peck C, Coleman G. Implications of placebo theory for clinical research and practice in pain management. Theoretical Medicine. 1991;12(3):247–270.
    1. Hyams JS. Treatment of functional gastrointestinal disorders associated with abdominal pain. Journal of Pediatric Gastroenterology and Nutrition. 2005;41(1):S47–S48.
    1. Dobrilla G, Comberlato M, Steele A, Vallaperta P. Drug treatment of functional dyspepsia. A meta-analysis of randomized controlled clinical trials. Journal of Clinical Gastroenterology. 1989;11(2):169–177.
    1. Allescher HD, Böckenhoff A, Knapp G, Wienbeck M, Hartung J. Treatment of non-ulcer dyspepsia: a meta-analysis of placebo-controlled prospective studies. Scandinavian Journal of Gastroenterology. 2001;36(9):934–941.
    1. Redstone HA, Barrowman N, van Veldhuyzen Zanten SJO. H2-receptor antagonists in the treatment of functional (nonulcer) dyspepsia: a meta-analysis of randomized controlled clinical trials. Alimentary Pharmacology and Therapeutics. 2001;15(9):1291–1299.
    1. Delaney B, Ford AC, Forman D, Moayyedi P, Qume M. Initial management strategies for dyspepsia. Cochrane Database of Systematic Reviews. 2005;(4) Article ID CD001961.
    1. Fisher RS, Parkman HP. Management of nonulcer dyspepsia. The New England Journal of Medicine. 1998;339(19):1376–1381.
    1. Wong WM, Wong BCY, Hung WK, et al. Double blind, randomised, placebo controlled study of four weeks of lansoprazole for the treatment of functional dyspepsia in Chinese patients. Gut. 2002;51(4):502–506.
    1. Hyman PE, Rasquin-Weber A, Fleisher DR, et al. Rome II: childhood functional gastrointestinal disorders. In: Drossman DA, editor. Rome II. The Functional Gastrointestinal Disorders. Diagnosis, Pathophysiology and Treatment: A multinational Consensus. 2nd edition. Lawrence, Kan, USA: Allen Press; 2000. pp. 533–575.
    1. Peura DA, Gudmundson J, Siepman N, Pilmer BL, Freston J. Proton pump inhibitors: effective first-line treatment for management of dyspepsia. Digestive Diseases and Sciences. 2007;52(4):983–987.
    1. Rudolph CD, Hanssal E. Gastroesophageal Reflux. Walker’s Gastointestinal Disease. 2008;4(2):66–71.

Source: PubMed

3
Sottoscrivi