{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:09:35Z","timestamp":1760238575294,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation, Ministry of Science and ICT of Korea","award":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"],"award-info":[{"award-number":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"]}]},{"name":"Yonsei University College of Medicine","award":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"],"award-info":[{"award-number":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"]}]},{"name":"Medical Institution","award":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"],"award-info":[{"award-number":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"]}]},{"name":"Gangnam Severance Hospital, Yonsei University College of Medicine","award":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"],"award-info":[{"award-number":["NRF-2020R1A2C1100753","6-2020-0074","6-2020-0133"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Refractory functional dyspepsia (RFD) is diagnosed when symptoms persist for at least 6 months despite at least two medical treatments. No consensus treatment guidelines exist. The implicated causes of functional biliary dyspepsia are a narrowed cystic duct, Sphincter of Oddi dysfunction, microlithiasis, and gallbladder dyskinesia. We investigated the treatment effects of litholytic agents. RFD patients were prospectively enrolled in six tertiary medical centers. All subjects took chenodeoxycholic and ursodeoxycholic acids (CNU) twice daily for 12 weeks. We monitored their medication adherence, laboratory results, and complications. The 7-point global symptom scale test scores were determined before and after treatment. Of the 52 patients who were prospectively screened, 37 were included in the final analysis. The mean age was 51.3 years: 14 were males, and 23 were females. Before treatment, the mean number and duration of symptoms were 2.4 and 48.2 months, and a mean of 3.3 FD-related drugs were taken. The mean CNU adherence was 95.3%. The mean global symptom scale score decreased from 5.6 pretreatment to 2.6 posttreatment. The symptom improvement rate was 94.6% (35 out of 37 patients). The only adverse event was mild diarrhea (10.8%) that was resolved after conservative management. Conclusions: CNU improved the symptoms of RFD patients who did not respond to conventional medications. Litholytic agents are good treatment options for patients with RFD and biliary dyspepsia secondary to biliary microlithiasis. Further prospective, large-scale mechanistic studies are warranted.<\/jats:p>","DOI":"10.3390\/jcm11113190","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T11:05:02Z","timestamp":1654167902000},"page":"3190","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Chenodeoxycholic Acid and Ursodeoxycholic Acid Treatments for Refractory Functional Dyspepsia"],"prefix":"10.3390","volume":"11","author":[{"given":"Sung Ill","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan 31151, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seok","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inha University School of Medicine, Incheon 22332, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Il","family":"Kwon","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-5805","authenticated-orcid":false,"given":"Dong Hee","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8477-6823","authenticated-orcid":false,"given":"Yoon Jae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6328-6948","authenticated-orcid":false,"given":"Hye Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2351-2370","authenticated-orcid":false,"given":"Min-Young","family":"Do","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4174-0091","authenticated-orcid":false,"given":"Jae Hee","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ki","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1136\/gutjnl-2014-307843","article-title":"Global prevalence of, and risk factors for, uninvestigated dyspepsia: A meta-analysis","volume":"64","author":"Ford","year":"2015","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1056\/NEJMra1501505","article-title":"Functional Dyspepsia","volume":"373","author":"Talley","year":"2015","journal-title":"N. 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