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Gut. 1997 May;40(5):587-90.

Double blind cross-over placebo controlled study of omeprazole in the treatment of patients with reflux symptoms and physiological levels of acid reflux--the "sensitive oesophagus".

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  • 1Department of Medicine, Queen's University, Belfast.

Abstract

BACKGROUND:

At least 10-15% of patients with reflux symptoms have a normal endoscopy and physiological levels of acid reflux on pH monitoring. Such patients with 50% or more of symptoms associated with acid reflux episodes have "a positive symptom index" (SI), and it has been proposed that this defines the "sensitive oesophagus".

AIM:

To test the response to omeprazole 20 mg twice daily for four weeks of patients with normal levels of acid reflux using a randomised, placebo controlled, double blind, cross-over design.

PATIENTS:

Eighteen patients with normal levels of reflux, 12 of whom had a positive SI.

METHODS:

Response was measured by symptomatic assessment and the SF-36 quality of life (QOL) questionnaire.

RESULTS:

Patients with a positive SI showed the following improvements on omeprazole compared with placebo: decrease in symptom frequency (p < 0.01), severity (p < 0.01) and consumption of antacids (p < 0.01). In the group with a negative SI only one patient clearly improved. The QOL parameters for bodily pain (65.6 v 53.4, p = 0.03) and vitality (60.6 v 48.8, p = 0.049) were significantly better on omeprazole than placebo for the group overall.

CONCLUSION:

Omeprazole improves symptoms in 11 of 18 patients with normal endoscopy and pH monitoring, particularly those with a positive SI. This supports the theory that such patients have an oesophagus which is "sensitive" to acid reflux and are part of the GORD spectrum.

PMID:
9203934
[PubMed - indexed for MEDLINE]
PMCID:
PMC1027158
Free PMC Article
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