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Kim YS, Kim N. Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences. J Neurogastroenterol Motil 2020; 26:322-334. [PMID: 32606255 PMCID: PMC7329152 DOI: 10.5056/jnm20026] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/11/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022] Open
Abstract
Functional dyspepsia (FD) is among the most common gastrointestinal disorders affecting quality of life (QoL). As it frequently occurs in women than in men the comparison of various aspects including prevalence, clinical manifestations, and QoL in FD between women and men is very important for understanding the disease distribution and burden, evaluating treatment options, developing new drugs, and allocating medical resources. However, little is known about sex or gender differences among patients with FD. In spite of limited studies, consistent points are that FD occurs more often in women than in men and there are several symptom differences between men and women with FD. In addition, women with FD tend to have lower QoL than men with FD. Similarly, the pathophysiology of FD likely to vary depending on gender. Furthermore, a sex-gender-oriented approach in healthcare system could enhance understanding heterogeneous patients suffering from FD. Due to the sex-gender differences in physiological and psychological factors, treatment strategies should differ between women and men with FD. In conclusion, an individualized and multicomponent approach that considers sex and gender issues might improve FD treatment and improve patient Qol, especially for women.
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Affiliation(s)
- Young Sun Kim
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Nayoung Kim
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Chuah KH, Mahadeva S. Cultural Factors Influencing Functional Gastrointestinal Disorders in the East. J Neurogastroenterol Motil 2018; 24:536-543. [PMID: 30153722 PMCID: PMC6175561 DOI: 10.5056/jnm18064] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/16/2018] [Accepted: 07/21/2018] [Indexed: 01/06/2023] Open
Abstract
Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functionalgastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptompresentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functionaldyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.
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Affiliation(s)
- Kee-Huat Chuah
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
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Choi MG, Rhee PL, Park H, Lee OY, Lee KJ, Choi SC, Seol SY, Chun HJ, Rew JS, Lee DH, Song GA, Jung HY, Jeong HY, Sung IK, Lee JS, Lee ST, Kim SK, Shin YW. Randomized, Controlled, Multi-center Trial: Comparing the Safety and Efficacy of DA-9701 and Itopride Hydrochloride in Patients With Functional Dyspepsia. J Neurogastroenterol Motil 2015; 21:414-22. [PMID: 26130637 PMCID: PMC4496904 DOI: 10.5056/jnm14117] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/29/2014] [Accepted: 01/07/2015] [Indexed: 01/19/2023] Open
Abstract
Background/Aims Therapies of functional dyspepsia (FD) are limited. DA-9701 is a novel prokinetic agent formulated with Pharbitis semen and Corydalis Tuber. We aimed to assess the efficacy of DA-9701 compared with itopride in FD patients. Methods Patients with FD randomly received either itopride 50 mg or DA-9701 30 mg t.i.d after a 2-week baseline period. After 4 weeks of treatment, 2 primary efficacy endpoints were analyzed: the change from baseline in composite score of the 8 dyspeptic symptoms and the overall treatment effect. Impact on patients’ quality of life was assessed using the Nepean Dyspepsia Index (NDI) questionnaire. Results We randomly assigned 464 patients with 455 having outcome data. The difference of the composite score change of the 8 symptoms between the 2 groups was 0.62, indicating that DA-9701 was not inferior to itopride. The overall treatment effect response rate was not different between the groups. When responder was defined as ≥ 5 of the 7 Likert scale, responder rates were 37% of DA-9701 and 36% of itopride group. Patients receiving DA-9701 experienced similar mean percentage of days with adequate relief during the 4-week treatment period compared with those receiving itopride (56.8% vs 59.1%). Both drugs increased the NDI score of 5 domains without any difference in change of the NDI score between the groups. The safety profile of both drugs was comparable. Conclusions DA-9701 significantly improves symptoms in patients with FD. DA-9701 showed non-inferior efficacy to itopride with comparable safety.
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Affiliation(s)
- Myung-Gyu Choi
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Hyojin Park
- Yonsei University College of Medicine, Seoul, Korea
| | - Oh Young Lee
- Hanyang University College of Medicine, Seoul, Korea
| | - Kwang Jae Lee
- Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
| | - Suck Chei Choi
- Wonkwang University College of Medicine, Iksan, Jeollabuk-do, Korea
| | | | | | - Jong-Sun Rew
- Chonnam National University College of Medicine, Gwangju, Korea
| | - Dong Ho Lee
- Seoul National University College of Medicine, Seoul, Korea
| | - Geun Am Song
- Pusan National University College of Medicine, Busan, Korea
| | | | - Hyung Yong Jeong
- Chungnam National University College of Medicine, Daejeon, Korea
| | | | - Joon Seong Lee
- Soonchunhyang University College of Medicine, Seoul, Korea
| | - Soo Teik Lee
- Chonbuk National University College of Medicine, Jeonju, Jeollabuk-do, Korea
| | - Sung Kook Kim
- Kyungpook National University College of Medicine, Daegu, Korea
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Li F, Sun G, Yang YS, Cui LH, Peng LH, Guo X, Wang WF, Yan B, Zhang L. Offshore training in navy personnel is associated with uninvestigated dyspepsia. ACTA ACUST UNITED AC 2014; 34:808-814. [PMID: 25480574 DOI: 10.1007/s11596-014-1357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 07/01/2014] [Indexed: 10/24/2022]
Abstract
To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.
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Affiliation(s)
- Fan Li
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China.,Department of Gastroenterology and Hepatology, Peking University International Hospital, Beijing, 102206, China
| | - Gang Sun
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yun-Sheng Yang
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Li-Hong Cui
- Department of Gastroenterology and Hepatology, The Navy General Hospital of The Chinese People's Liberation Army, Beijing, 100048, China.
| | - Li-Hua Peng
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xu Guo
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wei-Feng Wang
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Bin Yan
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Lanjing Zhang
- Department of Pathology, University Medical Center of Princeton, Plainsboro, 08536, USA.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, 08903, USA.,Department of Chemical Biology, Ernest Mario School of Pharmacy, Piscataway, 08854, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, 08903, USA
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