In a new study, it has been found that domperidone may be safe and effective to achieve remission of symptoms in children with abdominal pain in predominant functional gastrointestinal disorders (AP-FGIDs).The finding has been published in the Journal of Pediatric Gastroenterology and Nutrition.
Functional abdominal pain disorders (FAPDs), also called pain-predominant functional gastrointestinal disorders (FGIDs), are the most common cause of chronic abdominal pain in children. FAPDs involve interplay among regulatory factors in the enteric and central nervous systems. FAPD may be associated with visceral hyperalgesia, reduced threshold for pain, abnormal pain referral after rectal distension, or impaired gastric relaxation response to meals.
Dr Karunanayake A and associates s performed a randomised controlled trial to evaluate the therapeutic effect of domperidone on children with abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs). One hundred children (aged 5-12 years) fulfilling Rome III criteria for AP-FGIDs were randomized into 8 weeks of domperidone or placebo treatment.They were followed up for 6 months Cure rate. The patients reported general improvement, reduction in severity of abdominal pain, and increase in gastric motility index were analysed between both the groups.
It was found that after 8 wk, domperidone group showed a significantly higher patient-reported general improvement vs placebo group (74% vs 50%; P=.013), but there was no significant difference in cure rate between both the groups (44% vs 28%; P=.09). After a 6-months follow-up, cure rate (60% vs 38%; P=.028) and patient-reported general improvement (88% vs 66%; P=.009) were significantly higher in the domperidone group compared with placebo group. The domperidone group showed the significant reduction in severity of abdominal pain (54.1% vs 24.7%; P=.008) and an increase in the antral motility index (27.5% vs 7.2%; P=.029) after 8 wk. There was no significant difference in adverse events between both the groups.
The authors concluded that Domperidone may be a safe and effective therapeutic modality to achieve a lasting remission of symptoms in children with AP-FGIDs.“The exact mechanism of achieving symptomatic relief following domperidone in our study is not clear and this effect is unlikely to be related to the prokinetic properties of the drug,” the authors wrote.The authors call for future studies to find exact mechanism of pain reduction and overall sustainable clinical improvement in AP-FGIDs in children receiving treatment with domperidone.
For further reference log on to :
Karunanayake A, Devanarayana NM, de Silva A, Gunawardena S, Rajindrajith S. Randomized Controlled Clinical Trial on Value of Domperidone in Functional Abdominal Pain in Children. J Pediatr Gastroenterol Nutr. 2017 Nov 3 [Epub ahead of print]. doi: 10.1097/MPG.0000000000001819. PMID: 29112086
Dr. Kamal Kant Kohli
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