A randomized, three-way crossover clinical trial on the efficacy of Mastiha based therapies (Pistacia lentiscus var. Chia) in functional dyspepsia

Functional dyspepsia (FD) is a prevalent gastrointestinal disorder characterized by chronic upper abdominal symptoms and complex pathophysiology. Conventional therapies show limited efficacy, prompting interest in alternative approaches. Mastiha, is a natural resin with antioxidant, anti-inflammatory and prebiotic properties. Mastiha-water contains water-soluble components and essential oil traces. We aimed to evaluate the efficacy of Mastiha and Mastiha-water in alleviating FD symptoms and improving quality of life in a randomized, three-way crossover study conducted in Athens, Greece. Adult volunteers,diagnosed based on Rome IV Criteria and differential diagnosis were enrolled after written consent. They underwent a three-phase intervention, each lasting four weeks, with a 14-day washout period between interventions: (A) Mastiha capsules (1.4 g/day); (B) Mastiha-water (20 ml/day); (C) a no-intervention period. Primary outcomes were assessed using the Leuven Postprandial Distress Scale (LPDS). Secondary outcomes included quality of life, anxiety levels, and changes in medication. Statistical analysis was conducted on an intention-to-treat basis. Both Mastiha and Mastiha-water significantly improved FD symptoms compared to the no-intervention period (p < 0.001). Mastiha effectively reduced upper abdominal bloating, epigastric burning, and heartburn, while Mastiha-water improved quality of life (p = 0.012). In conclusion, Mastiha-based therapies may have a potential benefit in FD. Findings hereby support the selective use of Mastiha and Mastiha-water based on specific FD symptoms profile.ClinicalTrials.gov number: [NCT05687539].