Effects of omeprazole versus placebo in treatment of noncardiac chest pain and gastroesophageal reflux.

Gastroesophageal reflux (GER) occurs in 22-66% of patients with noncardiac chest pain (NCCP). Although open-label investigations have shown beneficial effects of antireflux therapy in NCCP, no double-blind, prospective, placebo-controlled studies have been conducted. The purpose of this study was to evaluate the effects of omeprazole compared to placebo in a prospective, double-blind, randomized trial of patients with NCCP and GER. Thirty-six consecutive patients with NCCP and GER documented by 24-hr ambulatory pH testing entered this study. The subjects were randomized to omeprazole, 20 mg by mouth twice a day (17 patients), or placebo (19 patients) for eight weeks. Patients on omeprazole obtained significantly more improvement in the fraction of chest pain days (P = 0.006) and severity (P = 0.032) when compared to placebo. More patients in the omeprazole group reported improvement in individual daily pain scores (81% vs 44%, P = 0.03) and individual severity scores (81% vs 50%, P = 0.057). Thirteen (81%) of the subjects in the treatment arm reported overall symptomatic improvement versus one (6%) in the placebo group (P = 0.001). The results of this study indicate that acid suppression with omeprazole effectively improves chest pain in patients with NCCP and GER.
AuthorsS R Achem, B E Kolts, T MacMath, J Richter, D Mohr, L Burton, D O Castell
JournalDigestive diseases and sciences (Dig Dis Sci) Vol. 42 Issue 10 Pg. 2138-45 (Oct 1997) ISSN: 0163-2116 [Print] UNITED STATES
PMID9365149 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Placebos
  • Proton Pump Inhibitors
  • Omeprazole
  • Chest Pain (drug therapy, physiopathology)
  • Double-Blind Method
  • Esophagus (drug effects, physiopathology)
  • Female
  • Follow-Up Studies
  • Gastric Acidity Determination
  • Gastroesophageal Reflux (drug therapy, physiopathology)
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Omeprazole (therapeutic use)
  • Peristalsis (drug effects)
  • Placebos
  • Prospective Studies
  • Proton Pump Inhibitors

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