{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:56:58Z","timestamp":1790852218856,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persistent gas\u2010predominant dyspeptic symptoms affect many patients despite adequate proton pump inhibitor (PPI) therapy, reflecting mechanisms beyond acid secretion. We evaluated the real\u2010world effectiveness and safety of simethicone (80\u2009mg) plus activated charcoal (250\u2009mg) in adults with persistent symptoms despite prior PPI therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, multicenter observational study across nine Indian sites, adults with persistent gas\u2010related symptoms despite \u2265\u20092\u2009weeks of standard\u2010dose PPI therapy received the combination thrice daily for 28\u2009days. Severity across 11 gastrointestinal domains was assessed using a modified Visual Analog Severity scale at baseline, Day\u201014, and 28. The primary outcome was change in symptom severity from baseline to Day 28, analyzed using Friedman testing with Bonferroni\u2010adjusted Wilcoxon post hoc comparisons. A global symptom score (mean of all 11 domains) was used for exploratory subgroup analyses; secondary outcomes included adherence and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 183 participants completed follow\u2010up, with significant reductions across all 11 symptoms (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Belching decreased from 46.3\u2009\u00b1\u200926.4 to 10.9\u2009\u00b1\u200919.5, epigastric burning from 48.1\u2009\u00b1\u200927.3 to 10.7\u2009\u00b1\u200917.9, and bloating from 44.2\u2009\u00b1\u200929.1 to 12.9\u2009\u00b1\u200918.6. Improvements were evident by Day\u201014 and sustained to Day\u201028. The median global symptom score reduction was 25.0\u2009units (95% CI: 22.7\u201327.3), with consistent improvement across demographic and clinical subgroups. Full adherence was 87.1% at Day 14 and 83.6% at Day 28, with no serious clinical events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with persistent gas\u2010predominant dyspepsia despite PPI therapy, simethicone\u2013activated charcoal was associated with significant short\u2010term symptomatic improvement. Controlled trials are warranted to confirm treatment effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70475","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:06:35Z","timestamp":1790849195000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multicenter, Prospective Real\u2010World Study of Simethicone\u2013Activated Charcoal in Patients With Persistent Dyspeptic Symptoms Despite Acid Suppression (\n                    <scp>SIMAC<\/scp>\n                    Study)"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6680-7227","authenticated-orcid":false,"given":"Ashish","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Sir Ganga Ram Hospital  Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. V.","family":"Sreenivas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Mythri Hospital  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8262-7533","authenticated-orcid":false,"given":"Sambit Kumar","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology MKCG Medical College  Berhampur Odisha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guduru Raghavendra Srinivas","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Yashoda Hospital  Secunderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. S. Sameer","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology Gleneagles Hospital  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9073-3985","authenticated-orcid":false,"given":"Jaya Ghosh","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peerless Hospital  Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nalini Kant","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Surgery Bokaro Surgical Clinic  Bokaro India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi Shankar","family":"Bagepally","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology Yashoda Hospitals  Secunderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shekhar","family":"Puri","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Samarpan Gastro &amp; Liver Clinic  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M. A.","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of General Medicine Dr. KNS Memorial Hospital (Mayo Medical Centre)  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Pathak","sequence":"additional","affiliation":[{"name":"Medical Affairs, Indchemie Health Specialities Pvt. Ltd.  India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6151-917X","authenticated-orcid":false,"given":"Shruti","family":"Pal","sequence":"additional","affiliation":[{"name":"Medical Affairs, Indchemie Health Specialities Pvt. Ltd.  India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"6","article-title":"Functional Dyspepsia: The Indian Scenario","volume":"60","author":"Ghoshal U. 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