Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia

Background: The two subgroups of Functional Dyspepsia (FD), including Postprandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS), can overlap. PDS–EPS overlap tends to reduce patients’ quality of life. Combination therapy with nizatidine and acotiamide may improve the symptoms of FD, in...

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Main Author: Yusaku Kajihara
Format: Article
Language:English
Published: Interna Publishing 2025-04-01
Series:The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
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Online Access:https://ina-jghe.com/index.php/jghe/article/view/1066
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author Yusaku Kajihara
author_facet Yusaku Kajihara
author_sort Yusaku Kajihara
collection DOAJ
description Background: The two subgroups of Functional Dyspepsia (FD), including Postprandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS), can overlap. PDS–EPS overlap tends to reduce patients’ quality of life. Combination therapy with nizatidine and acotiamide may improve the symptoms of FD, including PDS–EPS overlap. A previous study reported the combined effect of rabeprazole and acotiamide. This study aimed to evaluate nizatidine as an alternative to rabeprazole. Methods: This single-center retrospective study analyzed 66 patients with FD, including 45 and 21 patients receiving nizatidine/acotiamide and rabeprazole/acotiamide therapies, respectively. The regimen comprised nizatidine 150 mg twice daily, rabeprazole 10 mg once daily, and acotiamide 100 mg thrice daily. No prokinetics other than acotiamide (e.g., rikkunshito and mosapride) were simultaneously administered. The following characteristics were investigated: age, sex, diabetes mellitus, Parkinson’s disease, mental illness, subgroups of FD (PDS, EPS, or PDS–EPS overlap), and treatment-emergent adverse events. Symptom improvement rates following treatment were calculated and compared. Results: Although differences in the FD subgroups were significant in terms of patients’ backgrounds, no significant difference in PDS–EPS overlap rates was observed (55.6% [25/45] vs. 61.9% [13/21], p = 0.79). The difference in symptom improvement rates between nizatidine/acotiamide and rabeprazole/acotiamide therapies was not significant (86.7% [39/45] vs. 85.7% [18/21], p = 1). Conclusion: Nizatidine/acotiamide therapy demonstrated efficacy comparable to rabeprazole/acotiamide therapy in treating FD. Patients with FD frequently experience treatment difficulties owing to various underlying factors; however, nizatidine/acotiamide therapy with a high symptom improvement rate is a promising therapeutic option in refractory FD. Keywords: Dyspepsia, nizatidine, rabeprazole
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spelling doaj-art-32986acf3cd6401284d0a99b797dbdbc2025-08-20T02:25:59ZengInterna PublishingThe Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy1411-48012302-81812025-04-01261555810.24871/261202555-58917Effective Combination Therapy with Nizatidine and Acotiamide for Functional DyspepsiaYusaku Kajihara0Department of Gastroenterology, Fuyoukai Murakami Hospital, JapanBackground: The two subgroups of Functional Dyspepsia (FD), including Postprandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS), can overlap. PDS–EPS overlap tends to reduce patients’ quality of life. Combination therapy with nizatidine and acotiamide may improve the symptoms of FD, including PDS–EPS overlap. A previous study reported the combined effect of rabeprazole and acotiamide. This study aimed to evaluate nizatidine as an alternative to rabeprazole. Methods: This single-center retrospective study analyzed 66 patients with FD, including 45 and 21 patients receiving nizatidine/acotiamide and rabeprazole/acotiamide therapies, respectively. The regimen comprised nizatidine 150 mg twice daily, rabeprazole 10 mg once daily, and acotiamide 100 mg thrice daily. No prokinetics other than acotiamide (e.g., rikkunshito and mosapride) were simultaneously administered. The following characteristics were investigated: age, sex, diabetes mellitus, Parkinson’s disease, mental illness, subgroups of FD (PDS, EPS, or PDS–EPS overlap), and treatment-emergent adverse events. Symptom improvement rates following treatment were calculated and compared. Results: Although differences in the FD subgroups were significant in terms of patients’ backgrounds, no significant difference in PDS–EPS overlap rates was observed (55.6% [25/45] vs. 61.9% [13/21], p = 0.79). The difference in symptom improvement rates between nizatidine/acotiamide and rabeprazole/acotiamide therapies was not significant (86.7% [39/45] vs. 85.7% [18/21], p = 1). Conclusion: Nizatidine/acotiamide therapy demonstrated efficacy comparable to rabeprazole/acotiamide therapy in treating FD. Patients with FD frequently experience treatment difficulties owing to various underlying factors; however, nizatidine/acotiamide therapy with a high symptom improvement rate is a promising therapeutic option in refractory FD. Keywords: Dyspepsia, nizatidine, rabeprazolehttps://ina-jghe.com/index.php/jghe/article/view/1066dyspepsia, nizatidine, rabeprazole
spellingShingle Yusaku Kajihara
Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
dyspepsia, nizatidine, rabeprazole
title Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia
title_full Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia
title_fullStr Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia
title_full_unstemmed Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia
title_short Effective Combination Therapy with Nizatidine and Acotiamide for Functional Dyspepsia
title_sort effective combination therapy with nizatidine and acotiamide for functional dyspepsia
topic dyspepsia, nizatidine, rabeprazole
url https://ina-jghe.com/index.php/jghe/article/view/1066
work_keys_str_mv AT yusakukajihara effectivecombinationtherapywithnizatidineandacotiamideforfunctionaldyspepsia