Elsevier

Pharmacological Research

Volume 46, Issue 6, December 2002, Pages 525-531
Pharmacological Research

EFFECTS OF A BICARBONATE-ALKALINE MINERAL WATER ON GASTRIC FUNCTIONS AND FUNCTIONAL DYSPEPSIA: A PRECLINICAL AND CLINICAL STUDY

https://doi.org/10.1016/S1043661802002323Get rights and content

Abstract

The present study was performed in order to evaluate: (1) the influence of a bicarbonate-alkaline mineral water (Uliveto®) on digestive symptoms in patients with functional dyspepsia; (2) the effects of Uliveto® on preclinical models of gastric functions. Selected patients complained of dyspeptic symptoms in the absence of digestive lesions or Helicobacter pylori infection within the previous 3 months. They were treated with Uliveto® water (1.5 l day−1) for 30 days. Frequency and severity of symptoms were assessed at baseline and day 30 by a score system. Preclinical experiments were carried out on rats, allowed to drink Uliveto® or oligomineral water for 30 days. Animals then underwent pylorus ligation to evaluate gastric secretion of acid, pepsinogen, and mucus. In separate experiments, gastric emptying was assessed. Crenotherapy was associated with a relief of epigastric pain, retrosternal pyrosis, postprandial fullness and gastric distention. At preclinical level, Uliveto® water increased acid and pepsinogen secretions as well as gastric emptying, without changes in bound mucus. The enhancing actions of Uliveto® on gastric secretions and emptying were prevented by L-365,260, an antagonist of gastrin/CCK-2 receptors. These findings indicate that a regular intake of Uliveto® favors an improvement of dyspeptic symptoms. The preclinical study suggests that the clinical actions of Uliveto® water depend mainly on its ability to enhance gastric motor and secretory functions.

Section snippets

INTRODUCTION

Dyspepsia is a heterogeneous pathological condition characterized mainly by epigastric pain or discomfort in patients with normal endoscopic findings 1., 2.. The occurrence of dyspeptic symptoms represents a frequent reason for medical consultation in primary and secondary care, and it is now well recognized that structural (or organic) lesions of digestive tissues are found only in a minority of patients with dyspepsia 3., 4..

Dyspepsia, in the absence of a clinically identifiable structural

Patients and study design

The patients examined in this study were selected among those with uninvestigated dyspepsia who were referred by general practitioners to the endoscopy service of the Gastroenterology Units of Pisa University Hospital between January and June 2000. Among out-patients with normal upper endoscopy, only those with proven functional dyspepsia were admitted to the study. The inclusion criteria were: (a) history of dyspeptic symptoms lasting at least 3 months before entering the study; (b) presence

Clinical investigation

The group of patients, who met the inclusion criteria and were admitted to the study, consisted of 8 males and 10 females, aged between 25 and 75 years (median age: 52 years). At the time of enrollment (day 0) the prevalence of dyspeptic symptoms in the study group was as follows: epigastric pain, 9/18 (50%); epigastric burning, 9/18 (50%); postprandial fullness, 12/18 (67%); early satiety, 2/18 (11%); feeling of gastric distension, 8/18 (44%); nausea, 4/18 (22%); vomiting, 2/18 (11%);

DISCUSSION

Functional dyspepsia is characterized by a variety of symptoms usually referred to the upper digestive tract, the pathophysiology of which is still poorly understood [5]. At present, pharmacological treatments allow only a partial relief of symptoms in the majority of dyspeptic patients [6], and it has been suggested that some mineral waters might exert an adjuvant role in the medical management of dyspepsia, depending on their peculiar chemico-physical properties [11]. On this basis, the

References (26)

  • C. Blandizzi et al.

    CCK-1 and CCK-2 receptors regulate gastric pepsinogen secretion

    Eur. J. Pharmacol.

    (1999)
  • G. Varga et al.

    Camostate- and caerulein-induced delay of gastric emptying in the rat: effect of CCK receptor antagonists

    Eur. J. Pharmacol.

    (1996)
  • J.E. Richter

    Dyspepsia: organic causes and differential characteristics from functional dyspepsia

    Scand. J. Gastroenterol.

    (1991)
  • N.J. Talley et al.

    Functional gastroduodenal disorders

    Gut

    (1999)
  • N.J. Talley et al.

    Functional dyspepsia: a classification with guidelines for diagnosis and management

    Gastroenterol. Int.

    (1991)
  • P. Bytzer et al.

    Dyspepsia

    Ann. Intern. Med.

    (2000)
  • L. Agreus et al.

    Dyspepsia: current understanding and management

    Annu. Rev. Med.

    (1997)
  • G. Holtmann et al.

    Functional dyspepsia: current treatment recommendations

    Drugs

    (1993)
  • J.R. Malagelada

    Gastrointestinal motor disturbances in functional dyspepsia

    Scand. J. Gastroenterol.

    (1991)
  • C. Mansi et al.

    Comparative effects of levosulpiride and cisapride on gastric emptying and symptoms in patients with functional dyspepsia and gastroparesis

    Aliment. Pharmacol. Ther.

    (2000)
  • G. Dobrilla et al.

    Drug treatment of functional dyspepsia. A meta-analysis of randomized controlled trials

    J. Clin. Gastroenterol.

    (1989)
  • F. Grossi

    Influence of mineral waters on functional dyspepsia

    Clin. Ther.

    (1989)
  • M. Grassi et al.

    Dyspeptic syndrome. Aspects of physiopathology

    Clin. Ther.

    (1991)
  • Cited by (0)

    View full text