Theophylline improves esophageal chest pain--a randomized, placebo-controlled study

Satish S C Rao; Ranjit S Mudipalli; Jose M Remes-Troche; Craig L Utech; Bridget Zimmerman

doi:10.1111/j.1572-0241.2007.01112.x

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Theophylline improves esophageal chest pain--a randomized, placebo-controlled study

Journal article

Peer reviewed

Theophylline improves esophageal chest pain--a randomized, placebo-controlled study

Satish S C Rao, Ranjit S Mudipalli, Jose M Remes-Troche, Craig L Utech and Bridget Zimmerman

The American journal of gastroenterology, Vol.102(5), pp.930-938

05/2007

DOI: 10.1111/j.1572-0241.2007.01112.x

PMID: 17313494

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Abstract

The treatment of esophageal (noncardiac) chest pain is unsatisfactory and there is no approved therapy. A previous uncontrolled study suggested that theophylline may be useful. Our aims were to investigate the effects of theophylline on esophageal sensorimotor function and chest pain. In a double-blind study, sensory and biomechanical properties of the esophagus were assessed using impedance planimetry in 16 patients with esophageal hypersensitivity, after intravenous theophylline or placebo. In a second, randomized 4-wk crossover study, oral theophylline and placebo were administered to 24 patients with esophageal hypersensitivity. Frequency, intensity, and duration of chest pain episodes were evaluated. After IV theophylline, chest pain thresholds (P=0.027) and esophageal cross-sectional area (P=0.03) increased and the esophageal wall became more distensible (P=0.04) compared with placebo. After oral theophylline, the number of painful days (P=0.03) and chest pain episodes (P=0.025), pain duration (P=0.002), and its severity (P=0.031) decreased. Overall symptoms improved in 58% on theophylline and 6% on placebo (P<0.02). There was no order effect. Theophylline relaxed the esophageal wall, decreased hypersensitivity, and improved chest pain. Theophylline is effective in the treatment of functional chest pain.

Esophageal Diseases - drug therapy

Theophylline - therapeutic use

Phosphodiesterase Inhibitors - therapeutic use

Recurrence

Catheterization

Double-Blind Method

Humans

Middle Aged

Esophageal Diseases - complications

Male

Treatment Outcome

Electric Impedance

Chest Pain - drug therapy

Theophylline - administration & dosage

Phosphodiesterase Inhibitors - administration & dosage

Regression Analysis

Biomechanical Phenomena

Chest Pain - physiopathology

Chest Pain - etiology

Esophageal Diseases - physiopathology

Statistics, Nonparametric

Adult

Female

Aged

Details

Title: Subtitle: Theophylline improves esophageal chest pain--a randomized, placebo-controlled study
Creators: Satish S C Rao - Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA
Ranjit S Mudipalli
Jose M Remes-Troche
Craig L Utech
Bridget Zimmerman
Resource Type: Journal article
Publication Details: The American journal of gastroenterology, Vol.102(5), pp.930-938
Publisher: United States
DOI: 10.1111/j.1572-0241.2007.01112.x
PMID: 17313494
ISSN: 0002-9270
eISSN: 1572-0241
Grant note: RR00059 / NCRR NIH HHS DK57100-0441 / NIDDK NIH HHS
Language: English
Date published: 05/2007
Academic Unit: Biostatistics
Record Identifier: 9983997348302771

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