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Compared with placebo, H2 receptor antagonists (H2RAs) or prokinetics, how effective are proton pump inhibitors (PPIs) in people with functional dyspepsia (FD)?
PPIs were effective at reducing overall symptoms of FD, independent of the dose and duration of treatment. Treatment lasted from 2 weeks to over 6 weeks. The studies included in the analysis were generally of high methodological quality and a funnel plot found no evidence of publication bias. There was no evidence of a difference between PPIs and placebo on quality of life. There was no difference in the number of reported side effects when comparing PPIs, H2RAs and prokinetics.
The trials evaluating PPIs versus prokinetics were difficult to interpret as they were at risk of bias.
Several medicines are used to treat functional dyspepsia; PPIs and H2RAs reduce stomach acid, and prokinetics accelerate stomach emptying. There is no clear evidence that one medicine is more effective than another.
Pinto-Sanchez MI et al. Proton pump inhibitors for functional dyspepsia. Cochrane Reviews, 2017, Issue 11. Art. No.: CD011194.DOI: 10.1002/14651858. CD011194.pub3. This review contains 25 studies involving 8453 participants.
Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
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