Article

Hypersensitivity for capsaicin in patients with functional dyspepsia

Abteilung für Gastroenterologie und Hepatologie, Medical University of Vienna, Vienna, Austria.
Neurogastroenterology and Motility (Impact Factor: 3.42). 03/2008; 20(2):125-33. DOI: 10.1111/j.1365-2982.2007.00997.x
Source: PubMed

ABSTRACT The pathophysiology of functional dyspepsia is poorly understood, thus diagnostic and therapeutic options for this disease are limited. We assessed the relevance of a simple test for chemical hypersensitivity by applying an oral capsaicin load. After a preliminary dose-finding study, 61 healthy controls and 54 functional dyspepsia patients swallowed a capsule containing 0.75 mg capsaicin. A graded questionnaire evaluated severity of symptoms before and after capsule ingestion; an aggregate symptom score was calculated by adding all symptom scores. Controls developed moderate symptoms (symptom score: 6.0+/-4.1; median: 5.0). The 75% quartile (9.0) was considered the upper limit of normal. Functional dyspepsia patients had significantly higher symptom scores (10.0+/-6.5) than controls. About 54% of functional dyspepsia patients tested positive; clinically this group was not different from the group testing negative besides being on average younger and suffering more from bloating. In additional 13 patients with functional dyspepsia who tested positive (symptom score: 15.8+/-0.9), symptom response to placebo capsules (1.9+/-0.6) was similar to controls. In reliability testing, the Cronbach alpha-value of the capsaicin test was 0.86. The capsaicin test is a simple and non-invasive method to detect a subgroup of functional dyspepsia with chemical hypersensitivity.

Full-text

Available from: Johannes Matiasek, Nov 08, 2014
0 Followers
 · 
209 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs. Although adequate gastroprotection is indicated in individuals at high risk for upper gastrointestinal complications, underutilization of preventive strategies has been demonstrated. We investigated the utilization of proton pump inhibitors (PPIs) in high risk, short term users of NSAIDs and assessed the association between sociodemographic factors and the rates at which PPIs are prescribed. A retrospective study was conducted using data from 2.8 million individuals. Short term use was defined as an isolated period of NSAID use between 7 to 30 days. Logistic regression was performed to determine sociodemographic factors associated with PPI inhibitor use. A total of 155,825 short term users of NSAID were identified. Of these, 52,842 subjects (33.9%) had 1 or more risk factors; 56.1% of these subjects did not receive PPIs. Utilization was associated with sociodemographic factors of patients (such as older age [odds ratio (OR), 1.80; 95% confidence interval (CI), 1.64-1.99], female gender [OR, 1.14; 95% CI, 1.10-1.18], risk factors for upper gastrointestinal complications [OR, 3.72; 95% CI, 3.45-4.00]) and physicians (such as female gender [OR, 1.09; 95% CI, 1.03-1.14], practice in a deprived area [OR, 0.57; 95% CI, 0.53-0.61], or an urban area [OR, 0.86; 95% CI, 0.82-0.90]). Adequate gastroprotection is not provided to more than 50% of short term users of NSAIDs who are at an increased risk for upper gastrointestinal complications. Utilization is associated with sociodemographic factors of patients and physicians.
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 05/2009; 7(8):855-61. DOI:10.1016/j.cgh.2009.05.017 · 6.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic proton pump inhibitor (PPI) use is common in the Western world. Socio-economic status and socio-demographic factors have been shown to influence decisions related to prescribing of various drugs, but the influence of these factors on chronic PPI use is uncertain. To study the influence of SES and socio-demographic factors on chronic PPI use. Data were collected from a database of a Dutch health insurance company. Subjects having had at least one prescription for a PPI were identified and followed up for 6 months. Patients were then subdivided into chronic PPI users. Socio-demographic status was based on neighbourhood level of residence. Logistic regression was performed to determine socio-demographic factors associated with PPI use. A total of 2 001 787 insured individuals were included, 85 253 subjects were chronic users. Both low income (OR 1.55; CI 1.52-1.58) and low educational level (OR 1.33; CI 1.31-1.36) were associated with chronic PPI use. Other independent predictive variables included use of 10 or more concomitant medications (OR 5.33; CI 4.96-5.72) and the use of prokinetic drugs (OR 10.01; CI 9.22-10.88). Patients of a lower socio-demographic status are more likely to use PPIs on a chronic basis. The observed gradient in PPIs use may reflect differences in health, healthcare use or healthcare supply.
    Alimentary Pharmacology & Therapeutics 12/2008; 29(5):571-9. DOI:10.1111/j.1365-2036.2008.03900.x · 4.55 Impact Factor
  • Source
    The American Journal of Gastroenterology 11/2010; 105(11):2516. DOI:10.1038/ajg.2010.391 · 9.21 Impact Factor