Efficacy of acid suppression therapy

Abstract

There is no clear evidence yet on the best treatment for functional dyspepsia. A variety of drugs are used to try and relieve dyspepsia. Antisecretory drugs are one of the mainstays of treatment. In a Cochrane meta-analysis of randomized trials, antisecretory drugs (H2 receptor antagonists and proton pump inhibitors) were found to be more effective than placebos, and there were no differences between H2 receptor antagonists and proton pump inhibitors. The effectiveness is independent of the subtype, dose, duration of treatment, and Helicobacter pylori status in both drugs. The effect of Helicobacter pylori eradication therapy, on the symptoms of functional dyspepsia, is modest. The effect of H2 receptor antagonists and proton pump inhibitors therapy on functional dyspepsia may be overestimated because most existing trials were performed utilizing the Rome I and II classification of functional dyspepsia. More studies will be needed using the Rome IV criteria in the future, though meta-analyses suggest that acid suppressants are effective for the treatment of patients with functional dyspepsia. All trials to date followed up patients for less than 12 weeks. Trials evaluating therapies with a much longer follow-up will be required.