Indigestion

Comparative Efficacy and Safety of Stillen(®) and Rebamipide in Patients with Acute or Chronic Gastritis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

Lee H, Lim NR, Kim S, Cho H, Chung WC · Journal of clinical medicine · 2025

Background: Erosive gastritis has various causes, and severe damage to the mucosa can cause symptoms such as indigestion, abdominal pain, nausea, and vomiting. The condition is defined by visible erosions that emerge as discrete defects in the gastric mucosa. Stillen® is a natural mucosal-protective agent derived from Artemisia asiatica, but its comparative efficacy versus rebamipide remains unclear. This systematic review and network meta-analysis evaluated whether Stillen® leads to non-inferior endoscopic improvement outcomes compared to rebamipide in patients with acute or chronic gastritis. Methods: Databases including PubMed, EMBASE, Cochrane Library, RISS, KoreaMed, ClinicalTrials.gov, and ICTRP were searched through 15 August 2025. Eligible studies were randomized controlled trials (RCTs) comparing Stillen® with rebamipide or other mucosal-protective agents in gastritis. Two reviewers independently screened studies, extracted data, and evaluated the risk of bias.

Effectiveness and Safety of Varenicline for Smoking Cessation: An Overview and Meta-analysis.

Shang X, E F, Guo K, Yang C, Zhou L, Wu Y · Journal of addiction medicine · 2023

An overview, meta-analysis, and trial sequential analysis were conducted to evaluate the efficacy and safety of varenicline for smoking cessation. Systematic reviews (SRs) and randomized controlled trials evaluating varenicline versus placebo for smoking cessation were included. A forest plot was used to summarize the effect size of the included SRs. Traditional meta-analysis and trial sequential analysis (TSA) were performed using Stata software and TSA 0.9 software, respectively. Finally, the Grades of Recommendation, Assessment, Development, and Evaluation approach was used to assess the quality of evidence for the abstinence effect. A total of 13 SRs and 46 randomized controlled trials were included. Twelve review studies showed that varenicline was superior to placebo for smoking cessation. The meta-analysis results showed that, compared with the placebo, varenicline significantly increased the odds of smoking cessation (odds ratio = 2.54, 95% confidence interval = 2.20-2.94, P

Safety and efficacy of Xiaoyao-san for the treatment of functional dyspepsia: a systematic review and meta-analysis of randomized controlled trials.

Ha NY, Lee H, Jeong H, Ko SJ, Park JW, Kim J · Frontiers in pharmacology · 2023 · n=707

Objective: Although Xiaoyao-san (XYS) is a popular herbal remedy for indigestion, there is insufficient evidence to recommend it as a treatment option for functional dyspepsia (FD). This review aimed to assess the safety and efficacy of XYS in patients with FD, compared to conventional Western medicine (WM). Methods: Two independent reviewers searched for randomized controlled trials (RCTs) using 11 electronic databases, including Medline and Embase, to evaluate therapeutic effects of XYS on FD up to 31 January 2023. The primary outcome was the total clinical efficacy rate (TCE), and secondary outcomes included scores of dyspepsia-related symptoms (DSS) and incidence of adverse events (AEs). The risk of bias was evaluated using the Cochrane collaboration tool, and data synthesis and subgroup analyses were performed using the Review Manager program. Results: Six studies involving 707 participants were included in the meta-analysis. XYS significantly improved TCE compared to WM (RR = 1.1

Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.

Elwenspoek MM, Thom H, Sheppard AL, Keeney E, O'Donnell R, Jackson J · Health technology assessment (Winchester, England) · 2022

Coeliac disease is an autoimmune disorder triggered by ingesting gluten. It affects approximately 1% of the UK population, but only one in three people is thought to have a diagnosis. Untreated coeliac disease may lead to malnutrition, anaemia, osteoporosis and lymphoma. The objectives were to define at-risk groups and determine the cost-effectiveness of active case-finding strategies in primary care. (1) Systematic review of the accuracy of potential diagnostic indicators for coeliac disease. (2) Routine data analysis to develop prediction models for identification of people who may benefit from testing for coeliac disease. (3) Systematic review of the accuracy of diagnostic tests for coeliac disease. (4) Systematic review of the accuracy of genetic tests for coeliac disease (literature search conducted in April 2021). (5) Online survey to identify diagnostic thresholds for testing, starting treatment and referral for biopsy. (6) Economic modelling to identify the cost-effectiveness

Antihistamines and birth defects: a systematic review of the literature.

Gilboa SM, Ailes EC, Rai RP, Anderson JA, Honein MA · Expert opinion on drug safety · 2014

Approximately 10 - 15% of women reportedly take an antihistamine during pregnancy for the relief of nausea and vomiting, allergy and asthma symptoms, or indigestion. Antihistamines include histamine H1-receptor and H2-receptor antagonists. This is a systematic evaluation of the peer-reviewed epidemiologic literature published through February 2014 on the association between prenatal exposure to antihistamines and birth defects. Papers addressing histamine H1- or H2-receptor antagonists are included. Papers addressing pyridoxine plus doxylamine (Bendectin in the United States, Debendox in the United Kingdom, Diclectin in Canada, Lenotan and Merbental in other countries) prior to the year 2001 were excluded post hoc because of several previously published meta-analyses and commentaries on this medication. The literature on the safety of antihistamine use during pregnancy with respect to birth defects is generally reassuring though the positive findings from a few large studies warrant

Dyspepsia and gastro-oesophageal reflux disease: investigation and management

NICE

NICE guideline CG17 provides recommendations for the investigation and management of dyspepsia (indigestion) and gastro-oesophageal reflux disease in adults.

Clinical characteristics of duodenal-type follicular lymphoma.

Wang L, Shen W, Zhang X, Xue L, Hu B · Discover oncology · 2025

Duodenal-Type Follicular Lymphoma (DFL) is a rare extranodular B-cell lymphoma, which mainly involves the duodenum. It typically affects middle-aged individuals and occurs equally in both genders. Common symptoms include upper abdominal discomfort, pain, indigestion, etc. Histopathologically, the condition is characterized by the disruption of follicular architecture, accompanied by the hyperplasia of central cells, and may optionally exhibit the "starry sky" phenomenon. The main treatment for DFL is observation and waiting due to the lack of symptoms and slow progression. The article reviews recent insights into DFL's epidemiology, symptoms, treatment, and prognosis.

Natural Products in the Management of Gastroesophageal Reflux Disease: Mechanisms, Efficacy, and Future Directions.

Komolafe K, Komolafe TR, Crown OO, Ajiboye B, Noubissi F, Ogungbe IV · Nutrients · 2025

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that is defined by the reflux of gastric contents into the esophagus, and it results in symptoms such as esophageal inflammation, regurgitation, and indigestion. Although proton pump inhibitors (PPIs) and histamine-2 receptor antagonists are frequently employed to treat GERD, their prolonged administration is associated with adverse effects, necessitating the development of alternative therapeutic strategies. Natural products are now recognized as promising candidates for the management of GERD due to their bioactive compounds, which possess antioxidant, anti-inflammatory, and mucosal-protective properties. The potential of natural products in the treatment of GERD is comprehensively examined in this review, with a focus on their mechanisms of action, which include acid suppression, esophageal mucosal regeneration, anti-inflammatory activity, and gut microbiota modulation. Also, the efficacy and safety of key

Health-related quality of life among patients with gallstone disease: a systematic review and meta-analysis of EQ-5D utility scores.

Deborah YA, Haridoss M, Natarajan M, Joshua V, Bagepally BS · Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022 · n=189

Gallstone disease or cholelithiasis is a chronic illness that usually presents with pain in the abdomen, vomiting and indigestion leading to impaired quality of life. EQ-5D utility score is a validated measure of health-related quality of life (HRQoL). We systematically reviewed the literature and synthesised EQ-5D utility scores among patients with gallstone disease and its improvement on treatment. We have systematically searched observational studies reporting EQ-5D utility scores of gallstone disease in PubMed, Scopus, and Embase databases, from inception until February 2021. We selected the studies adhering to the PRISMA guidelines. The selected studies were reviewed, and the EQ-5D utility values of pre and post cholecystectomy were pooled using the random-effects model. From identified 4,817 records of database search, eleven studies predominantly from western countries with 2,189 participants were included for systematic review and meta-analysis. The pooled EQ-5D and visu

Ginger

NCCIH

This NCCIH fact sheet provides general information about ginger, including its uses, potential side effects, and scientific evidence regarding its effectiveness for various conditions like nausea and indigestion.

Peppermint Oil

NCCIH

This NCCIH fact sheet provides an overview of peppermint oil, including its traditional uses, what the science says about its effectiveness for conditions like IBS and indigestion, and safety considerations. It emphasizes that more research is needed for many of its purported uses.

Probiotics: What You Need To Know

NCCIH

This NCCIH fact sheet offers an overview of probiotics, covering what they are, common types, and the scientific evidence for their use in various health conditions, including digestive health. It aims to inform the public about the benefits and risks.

Clinical Trial to Assess the Efficacy and Safety of Combination Therapy of Motireb 5/100 mg in Functional Dyspepsia Patients.

n=354 · NCT02831543 · UNKNOWN · UNKNOWN

A phase Ⅲ, multi-center, randomized, double-blinded, placebo and active comparator clinical trial to assess the efficacy and safety of combination therapy of Motireb 5/100 mg in functional dyspepsia patients.

Efficacy of Motilitone on Gastric Emptying in Patients With Functional Dyspepsia:

n=78 · NCT02151708 · UNKNOWN · UNKNOWN

Functional dyspepsia (FD) is a disorder characterized by chronic or recurrent upper abdominal pain or discomfort in the absence of a specific structural cause.1 Several mechanisms have been suggested to underlie dyspeptic symptoms. In a barostat study by Tack et al.2, impaired gastric accommodation to a meal was found in 40% of patients with FD, and this abnormality was associated with early satiety. Delayed gastric emptying (GE) was also found in almost 40% of patients with FD, and was associated with the symptoms of postprandial fullness, vomiting and early satiety.3-5 Improving gastric accommodation and prokinetic effect seem to be an attractive physiological target in patients with FD. Motilitone (Dong-A ST, Yongin, Korea) is a new herbal drug that was launched in December 2011 in Korea for treating patients with FD. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia and prokinetic effects.6 The current study aims to evaluate effects of motilitone on gastric emptying and accommodation after a meal in patients with FD using three-dimensional gastric volume measurements by magnetic resonance imaging (MRI). Patients are randomly allocated to receive either motilitone 90 mg daily, motilitone 180 mg daily or placebo in a double blinded manner. After 2 weeks of treatment, patients undergo gastric MRI. The primary endpoint is gastric emptying rate. The secondary endpoints are gastric accommodation and symptom improvement.

Autonomic Reactivity to Restore a Dysregulated Brain-Gut Axis Via Targeted Therapy

n=120 · NCT06863207 · RECRUITING · RECRUITING

Disorders of gut-brain interaction (DGBI) affect up to 25% of U.S. children. Patients often suffer from disabling, multisystem comorbidities that suggest a common root (sleep disturbances, fatigue, anxiety, etc). Yet, DGBI are defined and treated based on GI symptom origin (cyclic vomiting, dyspepsia, irritable bowel) rather than underlying pathophysiology. Many patients manifest comorbidities suggesting an underlying autonomic nervous system (ANS) dysregulation (palpitations, dizziness, cognitive dysfunction). Unfortunately, due to common features of anxiety and visceral hyperreactivity and lack of obvious pathology, children with DGBI are frequently diagnosed with psychosomatic or 'benign, functional disorders' and treated with empiric antidepressants despite lack of scientific support and risks of serious side effects. Little is known about the underlying brain-gut mechanisms linking these comorbidities. A lack of targeted treatment options naturally follows the paucity of mechanistic data. A dysregulated ANS response circuit via brainstem nuclei is linked to visceral hypersensitivity. As the team's prior research has shown, ANS regulation can be non-invasively measured via several validated indices of cardiac vagal tone. Using the novel vagal efficiency (VE) metric, the investigators have demonstrated inefficient vagal regulation in cyclic vomiting syndrome and pain-related DGBI and that low VE predicts response to non-invasive, auricular percutaneous electrical nerve field stimulation (PENFS) therapy. PENFS targets brainstem vagal afferent pathways and, along with brain-gut interventions such as hypnotherapy, are the only therapies currently proven effective for pediatric DGBI. Individualizing neurostimulation based on sensory thresholds while assessing dynamic ANS reactivity offers a path towards personalized medicine using the most effective therapies to date. This proposal will test the feasibility of an ANS tracking software in assessing real-time, autonomic regulation and providing individualized neurostimulation in children with nausea/vomiting and ANS imbalance.

Cochrane reviews on Indigestion

Cochrane

The Cochrane Library provides access to systematic reviews of interventions for indigestion, summarizing evidence from randomized controlled trials.

Indigestion

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly find answers to their clinical questions using the best available evidence.

Cochrane Library Search: Functional dyspepsia

Cochrane

The Cochrane Library provides high-quality, independent evidence to inform healthcare decision-making, offering systematic reviews on various interventions for functional dyspepsia.