***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / AIMS Although antidepressants have been used for decades in treating patients with functional abdominal syndromes , how they influence gastrointestinal motility remains unclear . We aim ed to assess the role of depression in functional dyspepsia , and the effect of antidepressants on the functional dyspepsia patients ' symptoms and gastric myoelectrical activity . METHODOLOGY We conducted an open clinical trial with 40 functional dyspepsia patients .  Zung self-rating depression scale was used in evaluating the patients ' depression .  Cutaneous electrogastrography and evaluation of upper gastrointestinal symptoms  were performed before and after administration of a one-month course of fluoxetine . RESULTS In the baseline study , the depressed functional dyspepsia patients had higher symptom scores than non-depressed patients ( P < 0.05 ) . The depressed functional dyspepsia patients had higher percentages of tachygastria than healthy controls ( P < 0.05 ) , but the electrogastrography parameters of depressed and non-depressed functional dyspepsia patients were not different . After one-month fluoxetine treatment , the symptom scores improved significantly in the depressed functional dyspepsia patients ( P < 0.05 ) , but not in the non-depressed patients . Electrogastrography did not improve in either group . CONCLUSIONS Depressive functional dyspepsia patients had higher symptom scores and responded well to fluoxetine treatment . However , electrogastrography did not improve after the treatment . These findings suggest that depression is significant in the presentation of functional dyspepsia symptoms , but not correlated with gastric myoelectrical activity BACKGROUND The treatment of patients with functional dyspepsia remains unsatisfactory . We assessed the efficacy of itopride , a dopamine D2 antagonist with anti-acetylcholinesterase [ corrected ] effects , in patients with functional dyspepsia . METHODS Patients with functional dyspepsia were r and omly assigned to receive either itopride ( 50 , 100 , or 200 mg three times daily ) or placebo . After eight weeks of treatment , three primary efficacy end points were analyzed : the change from baseline in the severity of symptoms of functional dyspepsia ( as assessed by the Leeds Dyspepsia Question naire ) , patients ' global assessment of efficacy ( the proportion of patients without symptoms or with marked improvement ) , and the severity of pain or fullness as rated on a five- grade scale . RESULTS We r and omly assigned 554 patients ; 523 had outcome data and could be included in the analyses . After eight weeks , 41 percent of the patients receiving placebo were symptom-free or had marked improvement , as compared with 57 percent , 59 percent , and 64 percent receiving itopride at a dose of 50 , 100 , or 200 mg three times daily , respectively ( P<0.05 for all comparisons between placebo and itopride ) . Although the symptom score improved significantly in all four groups , an overall analysis revealed that itopride was significantly superior to placebo , with the greatest symptom-score improvement in the 100- and 200-mg groups ( -6.24 and -6.27 , vs. -4.50 in the placebo group ; P=0.05 ) . Analysis of the combined end point of pain and fullness showed that itopride yielded a greater rate of response than placebo ( 73 percent vs. 63 percent , P=0.04 ) . CONCLUSIONS Itopride significantly improves symptoms in patients with functional dyspepsia . ( Clinical Trials.gov number , NCT00272103 . ) In the present double-blind placebo-controlled study the effect of cisapride on functional dyspepsia was evaluated in patients with and without histological gastritis . Patients with functional dyspepsia and whose symptoms persisted after a 2 week run-in period with antacid treatment were r and omized to receive cisapride ( 10 mg ) or matching placebo three times daily for 4 weeks . Symptoms of epigastric pain , bloating , nausea , belching , early satiety and heartburn were grade d on a four-point scale based on patients ' feedback and diary card recording . A global response was also formulated by the investigators . One hundred and four patients entered the study and 76 completed the trial , comprising 36 patients with histological gastritis and 40 patients without gastritis .  Symptom scores in both gastritis and non-gastritis groups were significantly improved by both cisapride and placebo ; however , the improvement was not statistically different between the two treatment groups . Cisapride produced a good or better global response in 58 % of subjects with histological gastritis and in 53 % of subjects without gastritis compared with 47 % and 52 % , respectively , of patients on placebo ; this difference was not statistically significant . Gastric histology did not influence the effect of cisapride on the symptoms of functional dyspepsia Background : The use of proton pump inhibitors for the treatment of functional dyspepsia is controversial and the role of Helicobacter pylori infection in functional dyspepsia is uncertain . Aim : To evaluate the efficacy of different doses of lansoprazole for the treatment of functional dyspepsia in Chinese patients . Method : Patients with a clinical diagnosis of functional dyspepsia according to the Rome II criteria and normal upper gastrointestinal endoscopy were recruited and r and omised to receive : ( 1 ) lansoprazole 30 mg,(2 ) lansoprazole 15 mg , or ( 3 ) placebo , all given daily for four weeks . Dyspepsia symptom scores and quality of life ( SF-36 score ) were evaluated before and four weeks after treatment . Results : A total of 453 patients were r and omised . There was no difference in the proportion of patients with complete symptom relief in the lansoprazole 30 mg ( 23 % ) and lansoprazole 15 mg ( 23 % ) groups compared with the placebo group ( 30 % ) . The proportion of H pylori positive patients with a complete response was similar with lansoprazole 30 mg ( 34 % ) and lansoprazole 15 mg ( 20 % ) versus placebo ( 22 % ) . All symptom subgroups ( ulcer-like , dysmotility-like , reflux-like , and unspecified dyspepsia ) had similar proportions of patients with complete symptom relief after treatment . Conclusion : Proton pump inhibitor treatment is not superior to placebo for the management of functional dyspepsia in Chinese patients Background and aims : Patients with functional dyspepsia who have hypersensitivity to gastric distension have more prevalent pain , suggesting the presence of hyperalgesia . It is unclear whether this reflects activation of pain specific afferent pathways or multimodal afferent pathways that also mediate non-painful sensations . In the former case , hyperalgesia should occur when intensity of non-painful sensations is still low . The aim of the study was to analyse whether the symptom profile during gastric dissentions in functional dyspepsia patients with hyperalgesia reflects sensitisation of pain specific or multimodal pathways . Methods : Forty eight consecutive dyspeptic patients ( 35 female ) underwent gastric sensitivity testing with a barostat balloon using a double r and om staircase protocol .  At the end of every distending step , patients scored perception of upper abdominal sensations on a graphic 0–6 rating scale and completed visual analogue scales ( VAS 0–100 mm ) for pain , nausea , satiety , and fullness . The end point was a rating scale of 5 or more . Results : Hypersensitivity was present in 20 patients ( 40 % ) ; gastric compliance did not differ between normo- and hypersensitive patients . At maximal distension ( score 5 or more ) , hypersensitive patients had significantly lower distending pressures and intra-balloon volumes , but similar VAS scores for pain , nausea , satiety , and fullness compared with normosensitive patients . In both normosensitive and hypersensitive patients , elevation of pain VAS scores with increasing distending pressures paralleled the elevation in VAS scores for nausea , satiety , and fullness . Conclusions : Hypersensitive dyspeptic patients reach the same intensity of painful and non-painful sensations as normosensitive patients but at lower distending pressures . Hyperalgesia occurs in hypersensitive dyspeptic patients at distending pressures that also induce intense non-painful sensations . These findings argue against isolated upregulation of pain specific afferents in functional dyspepsia patients with visceral hypersensitivity Objectives Levosulpiride is the levo-enantiomer of sulpiride , a well-known antiemetic , antidyspeptic and antipsychotic drug . This study was undertaken to investigate the effects of levosulpiride on dyspeptic symptoms and gastric motor function in a group of patients with functional dyspepsia showing delayed gastric emptying . Method Forty two eligible patients were entered into a 3 week , double-blind r and omized comparison of 25 mg of levosulpiride or placebo t.i.d .. Symptom assessment  and  gastric scintigraphy  following the intake of scrambled egg s and wich , were performed in each patient before and after treatment . Results The improvement of symptom score in levosulpiride group was higher than the placebo group ( p<0.05 ) . We assessed global efficacy , which was excellent in 1 ( 6 % ) , good 11 ( 65 % ) , fair 4 ( 24 % ) , nil 1 ( 6 % ) of those receiving levosulpiride , and fair 9(60 % ) , nil 5 ( 33 % ) , poor 1 ( 6 % ) of those receiving placebo . Levosulpiride tended to be more effective than placebo in relieving the dyspeptic symptoms especially in the subgroups of dysmotility-like ( p<0.05 ) and nonspecific ( p<0.05 ) as compared to other subgroups ( p=0.16 ) . The reduction of gastric emptying time after levosulpiride treatment was more marked than Placebo group ( p<0.05 ) . We found a significant correlation between changes of symptom score and gastric emptying time ( r=0.47 , p=0.01 . No serious adverse effects were reported after administration of either levosulpiride or placebo . Only two patients reported mild somnolence during levosulpiride administration . Conclusions Levosulpiride is effective and well tolerated in patients with functional dyspepsia accompanied by delayed gastric emptying .  Its efficacy may be related to its action on the gastric motor function by improving the delayed gastric emptying AIM To compare ecabet sodium and cimetidine in relieving symptoms of functional dyspepsia . METHODS We performed a multi-center , prospect i ve , r and omized , double-blinded controlled trial to compare the clinical efficacy of ecabet sodium and cimetidine in patients with functional dyspepsia . Two-hundred and seventy-two patients with dyspeptic symptoms fulfilling the Rome-II criteria were enrolled from 7 centers . In the study group ( 115 patients ) , 1.5 g ecabet sodium was given twice a day . In the control group ( 121 patients ) , 400 mg cimetidine was given twice a day . Symptoms and parameters of quality of life were analyzed at baseline , 3 , 14 , and 28 d after initiating the treatment . RESULTS Two-hundred and thirty-six patients completed the clinical trial . After 4 wk of treatment , the rates of improvement in patients with dyspeptic symptoms were not different between two groups ( 77.4 % in the ecabet group and 79.3 % in the cimetidine group , respectively , P > 0.05 ) . Likewise , the rates of symptomatic improvement were not different at 3 d and 14 d. The parameters of quality of life did not change significantly during the study period in both groups . There was no clinical ly significant adverse event in both groups . CONCLUSION In patients with functional dyspepsia , ecabet sodium has similar clinical efficacy with cimetidine Background : The treatment of functional dyspepsia is controversial Altered visceral perception is common in functional dyspepsia ( FD ) . Dopaminergic pathways control gastrointestinal motility , but whether they modulate visceral sensitivity is unknown Nonulcer dyspepsia ( NUD ) is a common syndrome , but the optimal treatments have yet to be established . This study was performed to determine the most effectivetreatment for NUD . Subjects were recruited through the Department of General InternalMedicine at the Kyushu University Hospital because oftheir somatic symptoms . When no organic lesions werefound , the patients were directed to consult ourdepartment ( Psychosomatic Medicine ) ; 194 consecutive NUD patients were studied . All subjects were assessedpsychiatrically with the Structured Clinical Interviewfor DSM-III-R(SCID ) . Patients with serious NUD were hospitalized , and r and omly divided into control(N = 42 ) and experimental groups ( N = 86 ) . The controlswere treated with physical treatment alone . Theexperimental group received psychiatric treatment inaddition , based on the results of SCID . The experimentalgroup showed a significant improvement compared with thecontrols ( P < 0.0001 ) . The treatment for NUD takinginto consideration both the physical and psychiatric conditions is highly effective Aim : To compare the efficacy of simethicone with placebo and the prokinetic cisapride in patients with functional dyspepsia BACKGROUND & AIMS Hypersensitivity to proximal gastric distention as a result of abnormal central nervous system processing of visceral stimuli is a possible path 
    Output:
    
The exploratory comparison between classes of drugs revealed no significant difference in dyspeptic symptoms reduction between CNS and prokinetic drugs ; however CNS drugs were associated with a larger reduction in symptoms as compared with antisecretory drugs .
CONCLUSIONS The results show that both CNS and classic drugs are associated with a significant pain reduction in functional dyspepsia