The treatment of indigestion is a challenging and unsatisfying issue because so few medications have been analyzed and shown to be effective. Moreover, the drugs which were proven to be helpful haven’t been considerably effective for everyone.
Among the leading theories for the cause for indigestion is abnormalities in the manner the gastrointestinal muscles function. The function of muscles might be abnormally elevated, abnormally reduced, or they may be uncoordinated. There are medicines, called smooth muscle relaxants, which may decrease the activity of the muscles and other medicines that may raise the activity of the muscles (called promotility medicines) depending on what you need.
Various Medications Available
Most of the symptoms of indigestion may be explained on the basis of decreased activity of the gastrointestinal muscles which results in slowed transportation (transit) of foods through the belly and intestine. It is obvious, as mentioned previously, that there are several other causes of these symptoms along with slowed passage). Such symptoms include nausea, vomiting, and stomach bloating.
When transit is badly affected, abdominal distention (swelling) also may happen and may lead to abdominal discomfort. Early satiety is not likely to become a function of slowed transit since it happens too early for slowed transit to get outcomes. Theoretically, drugs that hasten the transit of foods should, in at least some individuals, alleviate symptoms of indigestion which are due to slow transit.
The amount of promotility medications which are offered to be used clinically is restricted. Studies in their effectiveness in indigestion are even more limited. The most studied drug is cisapride (Propulsid), a promotility drug which was removed from the marketplace due to serious cardiac side effects. Newer drugs, which have similar positive results but lack the negative toxicity, are now being developed. Cisapride was successful in patients with acute emptying difficulties of the abdomen (gastroparesis) or severely slowed passage of food in the small intestine (chronic intestinal pseudo-obstruction).
Another promotility drug that’s available is erythromycin, an antibiotic that stimulates gastrointestinal smooth muscle as one of its own side effects. Erythromycin is utilized to stimulate smooth muscles of the digestive tract at doses which are below those used for healing infections. There aren’t any studies of erythromycin in indigestion, but erythromycin is effective in gastroparesis and likely also in chronic intestinal pseudo-obstruction.
Metoclopramide (Reglan) is another promotility drug which is accessible in the United States. It hasn’t been analyzed, however, in dyspepsia. Furthermore, it’s connected with a few troubling side effects. For this reason, it might not be a great drug to undergo additional testing in dyspepsia.
Domperidone (Motilium) is a promotility drug which is accessible in the United States, but requires a special license from the US Food and Drug Administration. As an outcome, it’s not really commonly prescribed. It’s a powerful drug with minimal side effects.
The most extensively studied drugs for the medical treatment of stomach discomfort in functional problems are a number of drugs called smooth-muscle relaxants.
The alimentary canal is chiefly composed of a kind of muscle called smooth muscle. By comparison, skeletal muscles like the biceps consist of a kind of muscle called striated muscle. Smooth muscle relaxant drugs decrease the power of contraction of the smooth muscles but don’t change the contraction of other kinds of muscles. They’re found in functional disorders, especially IBS, together with the supposition (not proven) that powerful or lengthy contractions of smooth muscles within the gut spasms are the reason for the discomfort in functional disorders. There are even smooth muscle relaxants which are put underneath the tongue, as isnitroglycerin for angina, so they might be absorbed quickly.
There aren’t enough studies of smooth-muscle relaxants in indigestion to conclude they’re successful at decreasing pain. Because their negative effects are few, these medications likely are worth attempting. Just like all medicines which are provided to control symptoms, patients should carefully assess if the smooth-muscle relaxant they’re using is successful at managing the symptoms. If it’s not clearly effective, the choice of discontinuing the relaxant must be discussed with a doctor.