Effects of cetirizine on symptoms and gastric mucosal mast cells in patients with functional dyspepsia

Abstract

Background: Functional dyspepsia is considered one of the most common digestive diseases with tremendous cost and time expenditures for patients and health systems. An increase in the numbers of inflammatory cells such as mast cells and eosinophils are reported in the gastrointestinal mucosa of these patients. This study aims to determine the effects of histaminic receptor blockage on patients' clinical symptoms and mast cell counts of gastrointestinal mucosa. Materials and Methods: TThis study evaluated the effects of combined cetirizine and ranitidine on patients with proton pump inhibitor resistant functional dyspepsia in terms of clinical symptoms and mast cell counts in the gastric mucosa. Results: This study enrolled 31 patients. The patients declared the intensity of their symptoms as severe (in 12 patients) and very severe (in 19 patients) which significantly decreased after treatment. Three patients expressed dissatisfaction with the treatment. The mean mast cell count before treatment was 47.25±29.81 and after treatment it was 8.74±10.63, which was an 80.79±19.15% reduction (p<0.001). Postprandial distress syndrome was present in 25 (80.6%) patients and 13 (41.9%) had epigastric pain syndrome. Patients reported adverse events following treatment that included drowsiness (n=7), overeating (n=1), lethargy (n=1) and dry mouth (n=1). Conclusion: Combined treatment with cetirizine and ranitidine in patients with functional dyspepsia showed a significant reduction in the severity and number of mast cells in gastric mucosa and led to a high rate of satisfaction among patients.