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Minerva Medica 2017 December;108(6):489-95

DOI: 10.23736/S0026-4806.17.05320-4


lingua: Inglese

Gastric emptying and related symptoms in patients treated with buspirone, amitriptyline or clebopride: a “real world” study by 13C-octanoic Acid Breath Test

Gian P. CAVIGLIA 1 , Carlo SGUAZZINI 2, Fabio CISARÒ 2, Davide G. RIBALDONE 2, Chiara ROSSO 1, Sharmila FAGOONEE 3, Antonina SMEDILE 1, 2, Giorgio M. SARACCO 1, 2, Marco ASTEGIANO 2, Rinaldo PELLICANO 2

1 Department of Medical Sciences, University of Turin, Turin, Italy; 2 Unit of Gastroenterology and Hepatology, Città della Salute e della Scienza, Molinette Hospital, Turin, Italy; 3 Institute for Biostructures and Bioimages CNR c/o Molecular Biotechnology Center, University of Turin, Turin, Italy


BACKGROUND: Gastric motility is a key-factor in the pathogenesis of functional dyspepsia (FD). 13C-octanoic Acid Breath Test (OBT) is a tool used for measuring gastric emptying time in clinical setting. We aimed to investigate the variation in FD symptoms and OBT parameters after treatment with buspirone, amitriptyline or clebopride.
METHODS: Between Jan-2007 and Dec-2014, we enrolled 59 patients with FD unresponsive to first-line therapy with proton pump inhibitors and/or domperidone that underwent OBT before and after 3 months of buspirone (N.=32), amitriptyline (N.=16) or clebopride (N.=11) treatment.
RESULTS: Early satiation severity was positively correlated with gastric half emptying time (t1/2) (r=0.3789, P=0.003) and gastric lag phase (r=0.3371, P=0.011), and negatively correlated with gastric emptying coefficient (r=-0.3231, P=0.015). A reduction in t1/2 measurement in association to postprandial fullness, and early satiation severity improvement was observed (P=0.009, P=0.005 and P<0.001, respectively). Patients treated with buspirone obtained both a decrease in t1/2 (P=0.005) and an amelioration in early satiation (P=0.001). Patients under amitriptyline treatment experienced an improvement in postprandial fullness (P=0.046), whereas no variation was reported in patients treated with clebopride.
CONCLUSIONS: Patients with FD, non-responders to first-line therapy and reporting meal-related discomfort, may benefit from buspirone or amitriptyline-based therapies.

KEY WORDS: Breath tests - Dyspepsia - Gastrointestinal motility

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