Topical Mastic Oil for Treatment of Functional Dyspepsia: A Randomized , Triple-Blind Controlled Trial
DOI:
https://doi.org/10.31661/gmj.v10i.1965Keywords:
Functional Dyspepsia; Persian Medicine; Herbal Medicine; Clinical Trial; MasticAbstract
Background: The main goal of the present study was to evaluate the effect of topical mastic oil, compared to placebo on treatment of functional dyspepsia (FD). Materials and Methods: Sixty-three patients with FD were included. Thirty-two subjects received the topical mastic oil (10 drops/TDS after meal) with massage and 31 patients received topical sesame oil with massage. Both groups received pantoprazole (40 mg daily) along with oil and massage. The severity of early satiation, postprandial fullness, epigastric pain and epigastric burning was assessed after 4 weeks using the Visual Analogue Scale (VAS) as well as frequency of symptoms. Satisfaction with the treatment was also assessed using a researcher-made questionnaire. Changes in the severity of symptoms were evaluated by Friedman’s test. Results: Mean and standard deviation of age of the subjects were equal to 36.95±13.64 and 50 (79.4%) patients were female. Both groups experienced a significant decrease in the severity of all the four symptoms (P<0.001). The percentage of decrease in the severity of early satiation was significantly higher in the mastic group than the control group (76.03±34.91% vs. 37.24±38.86%, P=0.003). No significant differences were found in the percentage of decrease in the severity of postprandial fullness, epigastric pain and burning between the study groups (P=0.05, 0.06, and 0.13, respectively). The frequency of symptoms was decreased similarly in both groups. Satisfaction with the treatment was reported to be significantly higher in the mastic group than the sesame group (P=0.01). There were no intolerable side effects in both groups. Conclusion: Mastic oil reduced early satiation better than the placebo. In addition, satisfaction with the treatment was higher in the mastic group than the sesame group. [GMJ.2021;10:e1965]
References
Vakil NB, Howden CW, Moayyedi P, Tack J. White paper AGA: functional dyspepsia. Clin Gastroenterol Hepatol. 2017; 15(8): 1191-4. https://doi.org/10.1016/j.cgh.2017.05.013PMid:28529164 Miwa H, Kusano M, Arisawa T, Oshima T, Kato M, Joh T, et al. Evidence-based clinical practice guidelines for functional dyspepsia. J Gastroenterol. 2015; 50(2): 125-39. https://doi.org/10.1007/s00535-014-1022-3PMid:25586651 Talley NJ, Ford AC. Functional dyspepsia. N Engl J Med. 2015; 373(19): 1853-63. https://doi.org/10.1056/NEJMra1501505PMid:26535514 Eftekharafzali M, Mehrabani M, Tajadini H, Ahmadi B, Zahedi MJ. Effect of "Pistacia atlantica" Resin (Baneh) on Functional Dyspepsia: A Double-Blind, Randomized Clinical Study. Iran Red Crescent Med. J 2018; 20(7). https://doi.org/10.5812/ircmj.63822 Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P. Effect of dyspepsia on survival: a longitudinal 10-year follow-up study. Am J Gastroenterol. 2012; 107(6): 912-21. https://doi.org/10.1038/ajg.2012.69PMid:22472745 Talley NJ, cook DR. Functional dyspepsia. In: Lacy B, DiBaise J, Pimentel M, Ford A. Eds. Essential Medical Disorders of the Stomach and Small Intestine. 1st ed. Edinburgh: Springer, Cham; 2019:155-72. https://doi.org/10.1007/978-3-030-01117-8_8PMid:30640147 Suzuki H. The application of the Rome IV criteria to functional esophagogastroduodenal disorders in Asia. J Neurogastroenterol Motil. 2017; 23(3): 325. https://doi.org/10.5056/jnm17018PMid:28672431 PMCid:PMC5503281 Ghoshal UC, Singh R. Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population. J Gastroenterol Hepatol. 2017; 32(2): 378-87. https://doi.org/10.1111/jgh.13465PMid:27262283 Yang YJ, Bang CS, Baik GH, Park TY, Shin SP, Suk KT, et al. Prokinetics for the treatment of functional dyspepsia: Bayesian network meta-analysis. BMC Gastroenterol. 2017; 17(1): 83. https://doi.org/10.1186/s12876-017-0639-0PMid:28651565 PMCid:PMC5485548 Pinto-Sanchez MI, Yuan Y, Bercik P, Moayyedi P. Proton pump inhibitors for functional dyspepsia. Cochrane Database Syst Rev. 2017;11(11):CD011194. https://doi.org/10.1002/14651858.CD011194.pub2PMid:28271513 PMCid:PMC6464600 Sedighi GH, Maftoon F, Moshrefi M. Knowledge, attitude and use of complementary medicine in Tehran. Payesh. 2004; 3: 279-89. Tehrani SA, Asgharifard H, Haghdoost AA, Barghmadi M, Mohammadhosseini ON. The use of Complementary/Alternative Medicine among the general population in Tehran, Iran. Payesh. 2008; 7(4): 355-62. Thompson Coon J, Ernst E. Herbal medicinal products for non-ulcer dyspepsia. Aliment Pharmacol Ther. 2002; 16(10): 1689-99. https://doi.org/10.1046/j.1365-2036.2002.01339.xPMid:12269960 Carmona-Sánchez R, Tostado-Fernández FÃ. Prevalence of use of alternative and complementary medicine in patients with irritable bowel syndrome, functional dyspepsia and gastroesophageal reflux disease. Rev Gastroenterol Mexico. 2005; 70(4): 393-8. Nayernouri T. A Brief History of Ancient Iranian Medicine. Arch Iran Med. 2015; 18(8): 549-51. Babaeian M, Naseri M, Kamalinejad M, Ghaffari F, Emadi F, Feizi A, et al. Herbal Remedies for Functional Dyspepsia and Traditional Iranian Medicine Perspective. Iran Red Crescent Med J. 2015; 17(11): e20741. https://doi.org/10.5812/ircmj.20741PMid:26734483 PMCid:PMC4698144 Azimi M, Zahedi MJ. Persian herbal medicine in functional dyspepsia: a systematic review article. Curr Drug Discov Technol. 2020 Jun 11. https://doi.org/10.2174/1570163817666200611132831PMid:32525777 Pasalar M, Choopani R, Mosaddegh M, Kamalinejad M, Mohagheghzadeh A, Fattahi MR, et al. Efficacy and safety of Jollab to treat functional dyspepsia: a randomized placebo-controlled clinical trial. Explore. 2015; 11(3):199-207. https://doi.org/10.1016/j.explore.2015.02.007PMid:25777290 Hashem-Dabaghian F, Agah Sh, Taghavi-Shirazi M, Ghobadi A. Combination of Nigella sativa and Honey in Eradication of Gastric Helicobacter pylori Infection. Iran Red Crescent Med J. 2016; 18(11): e23771. https://doi.org/10.5812/ircmj.23771PMid:28191328 PMCid:PMC5292131 Tafti LD, Shariatpanahi SM, Damghani MM, Javadi B. Traditional Persian topical medications for gastrointestinal diseases. Iran J Basic Med Sci. 2017; 20(3): 222. Rauf A, Patel S, Uddin G, Siddiqui BS, Ahmad B, Muhammad N, et al. Phytochemical, ethnomedicinal uses and pharmacological profile of genus Pistacia. Biomed Pharmacother. 2017; 86: 39-404. https://doi.org/10.1016/j.biopha.2016.12.017PMid:28012394 Fazeli-nasab B, Fooladvand Z. Classification and Evaluation of medicinal plant and medicinal properties of mastic. Int J Adv Biol Biomed Res. 2014; 2(6): 2155-61. Safavi M, Shams-Ardakani MR, Sadat-Seyedbagheri M, Foroumadi A. The Efficacy of Iranian Traditional and Folk Medicinal Plants for Some Gastroduodenal Disorders. Tradit Integr Med. 2016; 3-17. Dabos KJ, Sfika E, Vlatta LJ, Giannikopoulos G. The effect of mastic gum on Helicobacter pylori: a randomized pilot study. Phytomedicine 2010; 17(3-4): 296-9. https://doi.org/10.1016/j.phymed.2009.09.010PMid:19879118 Choli-Papadopoulou T, Kottakis F, Papadopoulos G, Pendas S. Helicobacter pylori neutrophil activating protein as target for new drugs against H. pylori inflammation. World J Gastroenterol:WJG. 2011; 17(21): 2585. https://doi.org/10.3748/wjg.v17.i21.2585PMid:21677824 PMCid:PMC3110918 Shmuely H, Domniz N, Yahav J. Non-pharmacological treatment of Helicobacter pylori. World J Gastrointest Pharmacol Ther. 2016; 7(2): 171. https://doi.org/10.4292/wjgpt.v7.i2.171PMid:27158532 PMCid:PMC4848239 Khan I, Samson SE, Grover AK. Antioxidant supplements and gastrointestinal diseases: a critical appraisal. Med Princ Pract. 2017; 26(3): 201-17. https://doi.org/10.1159/000468988PMid:28278495 PMCid:PMC5588418 Triantafyllidi A, Xanthos T, Papalois A, Triantafillidis JK. Herbal and plant therapy in patients with inflammatory bowel disease. Ann Gastroenterol: Q Publ Hell Soc Gastroenterol. 2015; 28(2): 210. https://doi.org/10.1155/2015/197167PMid:25793189 PMCid:PMC4352452 Dabos KJ, Sfika E, Vlatta LJ, Frantzi D, Amygdalos GI, Giannikopoulos G. Is Chios mastic gum effective in the treatment of functional dyspepsia? A prospective randomised double-blind placebo controlled trial. J Ethnopharmacol. 2010; 127(2): 205-9. https://doi.org/10.1016/j.jep.2009.11.021PMid:19961914 Aghili khorasani MH: Gharabadin kabir . Tehran: Iran University of Medical Sciences Press; 2008. Suzuki H. The application of the Rome IV criteria to functional esophagogastroduodenal disorders in Asia. J Neurogastroenterol Motil. 2017; 23(3): 325. https://doi.org/10.5056/jnm17018PMid:28672431 PMCid:PMC5503281 Adam B, Liebregts T, Saadat-Gilani K, Vinson B, Holtmann G. Validation of the gastrointestinal symptom score for the assessment of symptoms in patients with functional dyspepsia. Aliment Pharmacol Ther. 2005; 22(4): 357-63. https://doi.org/10.1111/j.1365-2036.2005.02572.xPMid:16098003 Hu WH, Lam KF, Wong YH, Lam CL, HuIi WM, Lai KC, et al. The Hong Kong index of dyspepsia: a validated symptom severity questionnaire for patients with dyspepsia. J Gastroenterol Hepatol. 2002; 17(5): 545-51. https://doi.org/10.1046/j.1440-1746.2002.02713.xPMid:12084027 Van Zanten SV, Chiba N, Armstrong D, Barkun AN, Thomson ABR, Mann V, et al. Validation of a 7-point Global Overall Symptom scale to measure the severity of dyspepsia symptoms in clinical trials. Aliment Pharmacol Ther. 2006; 23(4): 521-9. https://doi.org/10.1111/j.1365-2036.2006.02774.xPMid:16441473 Aghili Khorasani MH: Moalejat-e Aghili. Tehran: Research Institute for Islamic and Complementary Medicine Press; 2009. Dennis K, Anthony F, Stephen H, Dan Longo J, Larry Jameson LJ. Harrison's principles of internal medicin. 19th ed. New York, NY: McGraw Hill; 2015. Meletis CD, Zabriskie N. Natural approaches for gastroesophageal reflux disease and related disorders. Altern Complement Ther. 2007; 13(2): 64-70. https://doi.org/10.1089/act.2007.13204 Cui KH. Mastic gum suppresses secretion of thymic stromal lymphopoietin in the asthmatic airway via NF-κB signaling pathway. Int J Clin Exp Med. 2016; 9(8): 15900-6. Miyamoto T, Okimoto T, Kuwano M. Chemical composition of the essential oil of mastic gum and their antibacterial activity against drug-resistant Helicobacter pylori. Nat Products Bioprospect. 2014; 4(4): 227-31. https://doi.org/10.1007/s13659-014-0033-3PMid:25089241 PMCid:PMC4111869 Paraskevopoulou A, Kiosseoglou V. Chios mastic gum and its food applications. In: Kristbergsson K, otles s. Eds. Functional Properties of Traditional Foods. 1st ed. Boston: Springer, MA; 2016:271-87. https://doi.org/10.1007/978-1-4899-7662-8_19PMid:26721498 Aghili khorasani Shirazi SMH; Makhzanoladvieh. Tehran, Iran: Institute of Medical History Studies of Islamic and Complementary Medicine; 2008.
