• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.3-8
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• 2016

Functional dyspepsia is one of the most common bowel disorders as prevalent of 7.7% Korean population. The cardinal manifestations include bothersome postprandial fullness, early satiation, epigastric burning or pain. These features are chronic and should be presented recurrently with no other compatible organic disease to explain the symptoms. Even though it is not life-shortening, functional dyspepsia usually make the health-related quality of life worse especially if other functional bowel disorder coexist. The coexistence of functional bowel disorders is called as 'overlap syndrome'. Anxiety, somatization and insomnia is more prevalent in overlap syndrome compared with sole functional bowel disorder. Therefore, it is worthwhile that physician interviews and elucidates whether the dyspeptic patient had other kinds of functional bowel disorders, and manages the underlying psychotic pathology. Placebo effect is large in functional dyspepsia, and there is only four kinds of prokinetics that is proven to be superior to placebo. Adverse events relating prolonged administration of prokinetics sometimes fatal or irreversible, physician willing to describe prokinetics should be familiar to the possible adverse effects and the relating risk factors. Pathologic acid reflux is not uncommon in functional dyspepsia, and acid-suppressant is equivalent to the prokientics in most of dyspeptic patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.30-37
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• 2008

The knowledge of motility disorders of the gastrointestinal tract has increased over the past decades. The development of newer therapies for bowel motility disorders has been disappointingly slow. Prokinetic agents are medications that enhance coordinated gastrointestinal motility and transit of material in the gastrointestinal tract. These agents are pharmacologically and chemically diverse. However, life-threatening adverse effects of prokinetic agents such as cisapride was present. In this review, pharmacologic effects and use of prokinetic agents in children was introduced.

• The Korean Journal of Food And Nutrition
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• v.10 no.2
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• pp.186-192
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• 1997

Endoscopic diagnosis and medical management from K43 and C45 patients, whose sex, occupation, character and life patterns are quite different each other, were discussed. The K43 was patient with erosive gastritis, which may caused by maldietary habits and life stresses. Although the effective drugs such as H2-receptor antagonists with atacids, H+/K+-pump inhibitors, prokinetics, colloidal bismuth, and sucralfates, were administrated for long time, symptomatic relief of abdominal pain was not improved. The tests of clinical phathology and abdominal sonogram were normal, visceral hypersensitivity was appeared from barostat test of stomach. However C45 had taken headache during every day life, and endoscopically confirmed as a gastric·duodenal ulcer patiant, which may caused by chronic use of NSAIDs. The her ulceric symptoms were suppressed from active stage to healing stage by using combination therapy for H. pylori with traditional antipeptic ulcer drugs, where as amitriptyline was administrated to the K43 but not effective. Nonulcer dyspepsia and irritable bowel syndrome is pooly defined, and affect about 15% of the population annually in U. S. A. but don't seek medical care. Author would like to point out that statistics for visceral pains are absent in Korea.

• Biomolecules & Therapeutics
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• v.21 no.3
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• pp.181-189
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• 2013

Motilitone$^{(R)}$ (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profile of DA-9701 is also preferable to that of other treatments.

• Korean Journal of Clinical Pharmacy
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• v.7 no.1
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• pp.22-32
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• 1997

The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.

• Journal of Veterinary Clinics
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• v.38 no.5
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• pp.231-234
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• 2021

A 14-month-old, intact female Maltese (case 1) and a 26-month-old, spayed female Dachshund (case 2) had persistent regurgitation over 1 year and 2 years, respectively. In both cases, there were not specific findings in blood examination. Diagnostic imaging and fluoroscopy revealed that gastroesophageal reflux (GER) occurred when the patients ate a barium meal without abdominal contraction. They were treated with proton-pump inhibitor (esomeprazole), sucralfate and prokinetics (cisapride) while in a standing position for an hour after every meal, according to the gastroesophageal disease (GERD) suggested treatment. The case 1 dog was discharged with improved clinical signs, and the case 2 dog also had been improved clinical signs; however, aspiration pneumonia occurred in case 2, which was thought to be a complication from GERD. After receiving treatment for aspiration pneumonia, the case 2 dog was discharged from the hospital. Since there was no further improvement in symptoms after discharge, the case 1 dog was euthanized by owner's request, and the case 2 is alive, having only mild clinical signs upon the writing of this paper.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.4
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• pp.300-311
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• 2022

Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children's Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months-18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller's myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.

• Korean Journal of Bronchoesophagology
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• v.10 no.2
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• pp.22-27
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• 2004

Background : LPRD(Laryngopharyngeal reflux disease) gives rise to inflammatory change in the pharyngolaryngeal tissue with various otolaryngologic symptoms. Ranitidine, histamine H2receptor antagonists, are currently used as therapeutic medications. However, the efficacy of Ranitidine on LPRD has not been proven yet. Objectives : We intended to analyze the efficacy of the Ranitidine on LPRD. Materials :md Methods : In 20 multicenter, 607 patients with LPR(laryngopharyngeal reflux) symptom were observed to evaluate their symptoms and laryngoscopic findings after 4 weeks, 8 weeks, and 12 weeks of treatment of Ranitidine. Results : The symptom of LPR including globus sensation, sore throat hoarseness, regurgitatioin are improved after 4 weeks $86.2\%,\;8 weeks\;91.5\%,\;12 weeks\;92.9\%$ of Ranitidine treatment and improved after 4 weeks $91.5\%,\;8 weeks\;94.5\%,\;12 weeks\; 97.2\%$ of Ranitidine combined with prokinetics. The rates of sore throat, chronic cough, globus sensation improvement at 8 weeks after treatment are $26.7\%,\;16.7\%,\;16\%$. Conclusion : In patient with LPR, Ranitidine treatment reduces LPR symptoms very effectively.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.2
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• pp.141-147
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• 2009

Background and Objectives: Although laryngopharyngeal reflux disease (LPRD) is a widely recognized disease in the field of otolaryngology, controversies still exist regarding the diagnosis and treatment for it. The purpose of this survey was to find out current trends in diagnosis and management of LPRD among Korean otolaryngologists. Materials and Method: Questionnaires were obtained from 26 Korean otolaryngology specialists by electronic balloting, and 46 members of the Korean Society of Head and Neck Surgery (KSHNS) bye-mail. Survey participants were asked about their preferences in diagnostic policy, duration/dosage of antireflux treatment, and their familiarity to the reflux symptom index (RST) and the reflux finding scores (RFS). Results: The majority of the survey participants (64%) preferred empiric therapy trial with proton pump inhibitors (PPIs) based on patients' symptoms and their laryngeal findings. PPIs alone (27%) or PPIs with prokinetics (32%) were usually prescribed as a first line treatment mostly with once daily schedule in the morning before meal and for less than 4 months of duration (86%). More than 90% of participants were aware of the RSI and RFS, but less than 50% of them were actually using those items in the clinics. Conclusion: Most of Korean otolaryngologists who participated in this survey answered that they prefer starting empirical treatments with proton pump inhibitors mainly based on the patient's symptoms and their laryngeal findings.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.254-263
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• 2015

Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.