ArticleJGH open : an open access journal of gastroenterology and hepatology2026
A Multicenter, Prospective Real-World Study of Simethicone-Activated Charcoal in Patients With Persistent Dyspeptic Symptoms Despite Acid Suppression (SIMAC Study).
Article in JGH open : an open access journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Persistent gas-predominant dyspeptic symptoms affect many patients despite adequate proton pump inhibitor (PPI) therapy, reflecting mechanisms beyond acid secretion. We evaluated the real-world effectiveness and safety of simethicone (80 mg) plus activated charcoal (250 mg) in adults with persistent symptoms despite prior PPI therapy. Methods: In this prospective, multicenter observational study across nine Indian sites, adults with persistent gas-related symptoms despite ≥ 2 weeks of standard-dose PPI therapy received the combination thrice daily for 28 days. Severity across 11 gastrointestinal domains was assessed using a modified Visual Analog Severity scale at baseline, Day-14, and 28. The primary outcome was change in symptom severity from baseline to Day 28, analyzed using Friedman testing with Bonferroni-adjusted 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. Results: All 183 participants completed follow-up, with significant reductions across all 11 symptoms (all Conclusion: In patients with persistent gas-predominant dyspepsia despite PPI therapy, simethicone-activated charcoal was associated with significant short-term symptomatic improvement. Controlled trials are warranted to confirm treatment effect.
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