Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy

Aim of investigation. To specify the association of symptoms, related to gastro-intestinal tract (GIT) and extraintestinal manifestations in patients with functional gastro-intestinal diseases (FGID) – functional dyspepsia (FD) and irritable bowel syndrome (IBS) – in comparison to group of patients...

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Main Authors: A. P. Pogromov, G. M. Dyukova, M. L. Leonova
Format: Article
Language:Russian
Published: Gastro LLC 2012-06-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/1296
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author A. P. Pogromov
G. M. Dyukova
M. L. Leonova
author_facet A. P. Pogromov
G. M. Dyukova
M. L. Leonova
author_sort A. P. Pogromov
collection DOAJ
description Aim of investigation. To specify the association of symptoms, related to gastro-intestinal tract (GIT) and extraintestinal manifestations in patients with functional gastro-intestinal diseases (FGID) – functional dyspepsia (FD) and irritable bowel syndrome (IBS) – in comparison to group of patients with organic gastro-intestinal diseases (OGID), strictly following diagnostic guidelines of Rome criteria-III. To study treatment efficacy of FD and IBS patients by selective serotonin and norepinephrine re-uptake inhibitor duloxetine.Material and methods. At physical examination analysis of complaints, past history, examination data was applied. Bristol stool scale (Rome-III 2006), laboratory and instrumental methods: upper endoscopy, colonoscopy, morphological study, Helicobacter pylori breath test, routine blood biochemical tests were used. Analysis of the «associated» or extraintestinal symptoms was carried out by Screening for Somatoform Symptoms questionnaire – SOMS-2 (Rief, 1996). Psychometric testing was performed: for depression level (Beck Depression Inventory), degree of alexithymia (TAS), anxiety level (Spielberger's State/Trait Anxiety Inventory). Analysis of childhood and actual psychogenias and psychophysiological reactions in the childhood. The scale of autonomous nervous disorders was applied for assessment of autonomous status (Vein et al., 1998), for evaluation of pain phenomena of various location – visual-analog scale.Results. At comparative analysis of gastroenterological symptoms in FGID and OGID patients in general it was revealed, that for majority of them no essential difference between organic and functional groups exits. Significant differences in predominance of esophageal complaints were revealed in FGID patients. Scores of associated symptoms and autonomous changes were significantly higher in FGID patients, as well as predominance of childhood psychogenias. Results of psychometric tests demonstrated, that in FGID patients the levels of depression and trait anxiety was significantly higher. According to aims of investigation all FGID patient received duloxetine treatment. After cessation of therapy all patients were monitored for one year with no relation to duration of treatment. After 8 wks of treatment clinical improvement was accomplished in the majority of patients, however preserved symptoms and signs have required continuation of therapy up to achievement of clinical remission. Duration of treatment was 4 to 9 months.Conclusions. At functional gastro-intestinal diseases psychopathologic and behavioural symptoms prevail in clinical pattern. No significant differences in gastrointestinal symptoms in patients with functional and organic gastro-intestinal diseases was found. Treatment of patients with the functional diseases by double-acting antidepressant duloxetine not only reduces psychological and autonomous nervous system disorders substantially, but also relieves main gastro-intestinal symptoms. Further studies for estimation of optimal dose and duration of treatment are requires.
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spelling doaj-art-f1201d91c64a40bc80fafdb2d7f273732025-02-10T16:14:32ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732012-06-012232632868Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacyA. P. Pogromov0G. M. Dyukova1M. L. Leonova2I.M. Sechenov First Moscow State Medical UniversityI.M. Sechenov First Moscow State Medical UniversityI.M. Sechenov First Moscow State Medical UniversityAim of investigation. To specify the association of symptoms, related to gastro-intestinal tract (GIT) and extraintestinal manifestations in patients with functional gastro-intestinal diseases (FGID) – functional dyspepsia (FD) and irritable bowel syndrome (IBS) – in comparison to group of patients with organic gastro-intestinal diseases (OGID), strictly following diagnostic guidelines of Rome criteria-III. To study treatment efficacy of FD and IBS patients by selective serotonin and norepinephrine re-uptake inhibitor duloxetine.Material and methods. At physical examination analysis of complaints, past history, examination data was applied. Bristol stool scale (Rome-III 2006), laboratory and instrumental methods: upper endoscopy, colonoscopy, morphological study, Helicobacter pylori breath test, routine blood biochemical tests were used. Analysis of the «associated» or extraintestinal symptoms was carried out by Screening for Somatoform Symptoms questionnaire – SOMS-2 (Rief, 1996). Psychometric testing was performed: for depression level (Beck Depression Inventory), degree of alexithymia (TAS), anxiety level (Spielberger's State/Trait Anxiety Inventory). Analysis of childhood and actual psychogenias and psychophysiological reactions in the childhood. The scale of autonomous nervous disorders was applied for assessment of autonomous status (Vein et al., 1998), for evaluation of pain phenomena of various location – visual-analog scale.Results. At comparative analysis of gastroenterological symptoms in FGID and OGID patients in general it was revealed, that for majority of them no essential difference between organic and functional groups exits. Significant differences in predominance of esophageal complaints were revealed in FGID patients. Scores of associated symptoms and autonomous changes were significantly higher in FGID patients, as well as predominance of childhood psychogenias. Results of psychometric tests demonstrated, that in FGID patients the levels of depression and trait anxiety was significantly higher. According to aims of investigation all FGID patient received duloxetine treatment. After cessation of therapy all patients were monitored for one year with no relation to duration of treatment. After 8 wks of treatment clinical improvement was accomplished in the majority of patients, however preserved symptoms and signs have required continuation of therapy up to achievement of clinical remission. Duration of treatment was 4 to 9 months.Conclusions. At functional gastro-intestinal diseases psychopathologic and behavioural symptoms prevail in clinical pattern. No significant differences in gastrointestinal symptoms in patients with functional and organic gastro-intestinal diseases was found. Treatment of patients with the functional diseases by double-acting antidepressant duloxetine not only reduces psychological and autonomous nervous system disorders substantially, but also relieves main gastro-intestinal symptoms. Further studies for estimation of optimal dose and duration of treatment are requires.https://www.gastro-j.ru/jour/article/view/1296functional gastro-intestinal diseasesirritable bowel syndromefunctional dyspepsiaselective serotonin and norepinephrine re-uptake inhibitorspsychological and autonomous nervous system changes
spellingShingle A. P. Pogromov
G. M. Dyukova
M. L. Leonova
Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
functional gastro-intestinal diseases
irritable bowel syndrome
functional dyspepsia
selective serotonin and norepinephrine re-uptake inhibitors
psychological and autonomous nervous system changes
title Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy
title_full Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy
title_fullStr Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy
title_full_unstemmed Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy
title_short Psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome, duloxetine treatment efficacy
title_sort psychological and autonomous nervous system features of functional gastric dyspepsia and irritable bowel syndrome duloxetine treatment efficacy
topic functional gastro-intestinal diseases
irritable bowel syndrome
functional dyspepsia
selective serotonin and norepinephrine re-uptake inhibitors
psychological and autonomous nervous system changes
url https://www.gastro-j.ru/jour/article/view/1296
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AT gmdyukova psychologicalandautonomousnervoussystemfeaturesoffunctionalgastricdyspepsiaandirritablebowelsyndromeduloxetinetreatmentefficacy
AT mlleonova psychologicalandautonomousnervoussystemfeaturesoffunctionalgastricdyspepsiaandirritablebowelsyndromeduloxetinetreatmentefficacy