Gastric Glitch: A New Functional Disease Treated with Buspirone and Prucalopride in an N-of-1 Double-Blind Clinical Trial

Incredible as it may seem, medical practitioners still come across unknown diseases. The care of adult patients with acute and severe epigastric pain shortly after drinking alcohol or coffee has attracted attention. Other striking features are the occurrence of the crisis in times of stress and when the drinks are ingested on an empty stomach. In the absence of organic diseases, this condition could refer to a new subtype of functional dyspepsia named gastric glitch. Currently, most patients with dyspepsia are treated with proton pump inhibitors (PPIs) or a prokinetic agent such as domperidone [4]. Studies have addressed the effect of other gastric desensitizers, such as buspirone and prucalopride [5, 6]. Buspirone relaxes the fundus, while prucalopride stimulates gastric emptying. We report results from an N-of-1 trial, testing the hypothesis that gastric glitch is provoked by alcohol intake and can be attenuated using buspirone or prucalopride. For this, a patient with highly reproducible glitch crises was treated at home with buspirone, prucalopride, or placebo in a random way before dinners with wine.