***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Eleven patients with symptoms of chronic postpr and ial idiopathic upper gastrointestinal distress served as their own controls in a clinical trial of a new prokinetic agent , domperidone . After evaluations to eliminate the presence of anatomic lesions , each subject was given domperidone and placebo in r and om order for one month . Using a symptom-scoring question naire , no superiority of domperidone over placebo could be demonstrated in the group as a whole . Improvement in two out of three patients with diabetic gastroparesis , however , was noted . Side-effects possibly related to domperidone consisted of gas pains and skin rash in one patient each OBJECTIVE : The aim of this study was to compare symptoms for patients with uninvestigated dyspepsia and a negative Helicobacter pylori serology who were treated with cisapride or placebo .  METHODS : Helicobacter pylori-seronegative patients with chronic dyspepsia were r and omized to receive cisapride 10 mg t.i.d . or placebo t.i.d . for 30 days . Symptom scores were performed 1 month and 3 months after r and omization . Outcomes measured were dyspepsia symptom scores and a treatment “ success ” variable defined as absence of symptoms or decrease in the most severe individual symptom by two grade s. RESULTS : A total of 60 patients were r and omized ; 56 completed the 1-month follow-up and 40 completed the 3-month follow-up interview . The mean score for all patients at the time of entry was 11.0 and declined to 8.3 and 8.2 at 1 and 3 months , respectively , after r and omization . At 1 month and 3 months after r and omization , there was no significant difference in the number of patients meeting the “ success ” variable for patients receiving cisapride as compared to placebo . The mean decline in symptom severity scores was not significantly different for patients receiving placebo or cisapride at 1 month ( mean , −2.8 vs−3.1 ; difference = 0.3 , p = 0.74 ) or 3 months ( −3.1 vs−2.6 , difference = −0.5 , p = 0.58 ) after r and omization . CONCLUSIONS : No significant difference in the severity of dyspeptic symptoms was found for patients receiving cisapride as compared to placebo in the setting of uninvestigated dyspepsia and a negative Helicobacter pylori serology The aim of this study was to determine the effect of colloidal bismuth subcitrate ( De Nol ) on symptoms and gastric histology in patients with non-ulcer dyspepsia . In a single centre trial , patients with food related upper abdominal pain not caused by ulcer disease were r and omised to receive one tablet of colloidal bismuth subcitrate or matching placebo four times daily for eight weeks . Seventy three patients were entered and 51 completed the trial : 28 patients in the colloidal bismuth subcitrate group and 23 in the placebo group . Overall there was no difference between the two groups in terms of symptom relief . Among patients with histological gastritis ( n = 23 ) , however , those who took colloidal bismuth subcitrate used fewer antacid tablets ( for three of four fortnightly periods ) and were more likely to become asymptomatic ( eight of 11 v three of 12 , p less than 0.05 ) ; their gastritis was more likely to resolve ( five of 10 v 0 of 12 , p less than 0.025 ) and their gastric biopsies more likely to become negative for Helicobacter like organisms ( eight of nine v 0 of 12 , p less than 0.001 ) when compared with patients taking placebo . In contrast , patients who did not have gastritis in their index biopsies ( n = 28 ) fared similarly whether they received colloidal bismuth subcitrate or placebo . Our results indicate that the administration of colloidal bismuth subcitrate benefited non-ulcer dyspepsia patients with gastritis but had no effect on those without Background : Cisapride has an established prokinetic effect in patients with delayed gastric emptying . However , rectal administration of the drug might be preferred in patients with either dysphagia or nausea due to gastroparesis PURPOSE The efficacy of proton pump inhibitor therapy for symptom resolution in patients with functional dyspepsia remains controversial . This study was design ed to compare the efficacy of lansoprazole with placebo in relieving upper abdominal discomfort in patients with functional dyspepsia . METHODS We enrolled 921 patients with functional dyspepsia ( defined as persistent or recurrent upper abdominal discomfort during the prior 3 months ) and moderate upper abdominal discomfort on at least 30 % of screening days ; none of the patients had predominant symptoms suggestive of gastroesophageal reflux or endoscopic evidence of erosive or ulcerative esophagitis , or gastric or duodenal ulcer or erosion . Patients were assigned r and omly to receive lansoprazole 15 mg ( n = 305 ) , lansoprazole 30 mg ( n = 308 ) , or placebo ( n = 308 ) daily for 8 weeks . Patients recorded the frequency and severity of symptoms in daily diaries . RESULTS At week 8 , significantly ( P < 0.001 ) greater mean reductions in the percentage of days with upper abdominal discomfort were reported in patients treated with lansoprazole 15 mg ( 35 % ) or 30 mg ( 34 % ) compared with those treated with placebo ( 19 % ) . Similarly , more patients treated with lansoprazole 15 mg ( 44 % ) or 30 mg ( 44 % ) reported complete symptom resolution ( defined as no episodes of upper abdominal discomfort in the 3 days before the study visit ) at 8 weeks than did placebo-treated patients ( 29 % , P < 0.001 ) . Improvement of upper abdominal discomfort , however , was seen only in patients who had at least some symptoms of heartburn at enrollment . CONCLUSION Lansoprazole , at a daily dose of 15 mg or 30 mg , is significantly better than placebo in reducing symptoms of persistent or recurrent upper abdominal discomfort accompanied by at least some symptoms of heartburn Dopamine antagonists are effective anti-emetics . Domperidone does not readily cross the blood-brain barrier and is less likely to cause central nervous system side-effects than metoclopramide . However , a direct comparison of the safety and efficacy of the two drugs has not hitherto been made . Ninety-five patients , with symptoms of nausea and vomiting due to a variety of oesophageal or gastric disorders , were recruited into a r and omised , double-blind , three-part , parallel-group comparative study of controlled release metoclopramide 15 mg ( Gastrobid Continus tablets , Napp Laboratories ) given twice daily , and domperidone 10 mg or 20 mg given three times daily . Assessment s for nausea , vomiting , reflux symptoms and adverse events were made on entry to the study . Patients were r and omly allocated to one of the three treatment regimes for a period of seven days , throughout which daily symptomatology and use of escape medication were recorded on a diary card . At the end of the treatment period , nausea , vomiting and reflux symptoms , adverse events and a global assessment of patients ' symptom control were recorded by the investigator . Both controlled release metoclopramide and high and low dose domperidone significantly reduced symptoms of belching , flatulence , distension , heartburn , regurgitation , reflux , nausea and vomiting compared to baseline . There were no significant differences between the three treatments in efficacy or in the number and severity of side-effects A double-blind , placebo-controlled trial was performed , using 400-mg cimetidine tablets or placebo twice daily for 4 weeks in 100 patients with non-ulcer dyspepsia ( NUD ) and erosive prepyloric changes ( EPC ) grade 2 or 3 . Symptomatic assessment was made weekly and endoscopic assessment on completion of the treatment period . Symptomatically , a significant effect of cimetidine versus placebo on epigastric pain/discomfort was recorded after 2 weeks ' treatment ( p less than 0.05 ) . Endoscopically , there was a significant improvement , according to our grading scale of EPC , in the cimetidine-treated group , as compared to the placebo-treated group ( p less than 0.05 ) . On the basis of our findings , patients with NUD and EPC who have epigastric pain/discomfort as a prominent symptom seem to profit from treatment with cimetidine The efficacy of sucralfate in the treatment of patients with dyspepsia and macroscopic signs of gastritis was assessed in a double-blind , placebo-controlled study . Treatment was 2 g sucralfate or placebo taken 1/2 h before breakfast and at bedtime . Clinical and endoscopic examinations were performed after 6 weeks ' treatment , and if mucosal changes and /or symptoms persisted , medication was continued for another 6 weeks . Cumulative healing rates at 6 and 12 weeks were 43 % ( 13 of 30 ) and 62 % ( 18 of 29 ) in the sucralfate group verus 37 % ( 11 of 30 ) and 62 % ( 18 of 29 ) in the placebo group . Corresponding rates for symptomatic improvement were 80 % and 83 % for those receiving sucralfate and 73 % and 79 % for placebo-treated patients . None of the differences between sucralfate and placebo were significant , and sucralfate does not seem to be superior to placebo in the treatment of macroscopic gastritis BACKGROUND Patients with functional dyspepsia ( FD ) have more complaints than just the dyspepsia . METHOD One hundred FD patients were assessed with regard to psychologic , medical , and social factors , before r and omization , in a study of cognitive therapy . They were asked to list their main problem areas or ' target complaints ' . RESULTS Dyspepsia was the third most frequent target complaint ( 26 patients ) , and anxiety was the most frequent one ( 65 patients ) . Patients identifying dyspepsia as a target complaint differed from the other FD patients in several aspects . They had significantly more dyspeptic symptoms ( p < 0.05 ) and scored significantly higher on multiple somatic complaints ( p = 0.001 ) , depression ( p = 0.025 ) , general psychopathology ( p = 0.043 ) , the global assessment scale ( p = 0.001 ) , and the General Health Question naire ( p = 0.040 ) . However , they did not have more somatic predisposing factors like consumption of alcohol and coffee or infection with Helicobacter pylori than the patients with other target complaints . CONCLUSIONS Anxiety and not dyspepsia was the most frequent target complaint , and patients who identified dyspepsia as a target complaint did not have more somatic predisposing factors Sixty patients with nonulcer dyspepsia took cimetidine 1 g daily or a placebo for 5 weeks in a double-blind trial . Thirty-four men and 26 women with normal double-contrast barium meals were included . Five percent had the endoscopic appearances of duodenitis . Symptoms improved during treatment in 62 % of those taking cimetidine and in 54 % of the placebo group ( NS , p = 0.5 ) . We suggest that significant duodenitis is uncommon in the absence of active or quiescent duodenal ulcer disease . From this study there is no evidence that cimetidine benefits those patients with normal double-contrast barium meals and no duodenitis endoscopically who nonetheless have symptoms similar to those of peptic ulcer disease Duodenogastric reflux has a deleterious effect on the gastric mucosa . It was the aim of this study to assess the acute effects of cisapride on antroduodenal motility and duodenogastric reflux in seven patients with severe dyspepsia and increased biliary reflux , as evidence d by increased bile salt output in their gastric aspirates . Each patient underwent two studies on separate days . On each day , after an overnight fast , each patient swallowed a multilumen tube for manometric recording of gastroduodenal motility . Phenol red was infused into the second portion of the duodenum , gastric juice was aspirated , and motor activity was monitored for 90 min . At the end of this period , the patient received either cisapride or placebo intravenously in a double-blind r and omized fashion . Antroduodenal motility and duodenogastric reflux were monitored for the subsequent 90 min . A significantly ( P<0.01 ) higher motility index was found in the antrum after cisapride ( 2678±712 vs 1110±412 in the basal period ) while placebo had no effect . The duodenal motility index was not affected by cisapride or placebo . Bile salt outputs in gastric aspirates were significantly ( P<0.05 ) reduced following cisapride injection ( 0.42±0.6 mmol vs 1.6±1.2 mmol during basal period ) . Conversely , outputs of phenol red in the gastric aspirates were unaffected by cisapride . In conclusion , cisapride  stimulates antral motility and decreases biliary reflux in patients with dyspepsia and increased duodenogastric refl 
    Output:
    
REVIEW ER 'S CONCLUSIONS There is evidence that anti-secretory therapy may be effective in NUD .