TY - JOUR
T1 - An open-label trial of theophylline for functional chest pain
AU - Rao, Satish S.C.
AU - Mudipalli, Ranjit S.
AU - Mujica, Victor
AU - Utech, Craig L.
AU - Zhao, Xing
AU - Conklin, Jeffrey L.
N1 - Funding Information:
This work was supported in part by a grant from the Central Investment Fund for Research Enhancement, University of Iowa and by National Institutes of Health grant RO1 DK-57100-02.
PY - 2002/12/1
Y1 - 2002/12/1
N2 - Visceral hypersensitivity may play a role in the pathogenesis of functional chest pain, although the underlying mechanism(s) is unknown. We investigated the effects of theophylline, an adenosine receptor antagonist, on sensory perception and biomechanical properties of esophagus in patients with functional chest pain. Esophageal balloon distention was performed using impedance planimetry in 21 consecutive patients with functional chest pain. Patients found to have a hypersensitive esophagus received intravenous theophylline and balloon distension was repeated. If the hypersensitivity improved, oral theophylline was prescribed for three months as an open label trial. Balloon distension reproduced typical chest pain in 16 (76%) patients at thresholds suggestive of hypersensitivity. After theophylline infusion, pain thresholds increased in 12 (75%) patients. Median threshold pressures for discomfort and pain improved (P < 0.01). Cross-sectional area increased (P < 0.05) and the tension/strain association shifted to the right (P < 0.01). Seven of eight patients reported sustained improvement in pain after oral theophylline. Theophylline may ameliorate chest pain in patients with hypersensitive esophagus, possibly by altering adenosine-mediated nociception.
AB - Visceral hypersensitivity may play a role in the pathogenesis of functional chest pain, although the underlying mechanism(s) is unknown. We investigated the effects of theophylline, an adenosine receptor antagonist, on sensory perception and biomechanical properties of esophagus in patients with functional chest pain. Esophageal balloon distention was performed using impedance planimetry in 21 consecutive patients with functional chest pain. Patients found to have a hypersensitive esophagus received intravenous theophylline and balloon distension was repeated. If the hypersensitivity improved, oral theophylline was prescribed for three months as an open label trial. Balloon distension reproduced typical chest pain in 16 (76%) patients at thresholds suggestive of hypersensitivity. After theophylline infusion, pain thresholds increased in 12 (75%) patients. Median threshold pressures for discomfort and pain improved (P < 0.01). Cross-sectional area increased (P < 0.05) and the tension/strain association shifted to the right (P < 0.01). Seven of eight patients reported sustained improvement in pain after oral theophylline. Theophylline may ameliorate chest pain in patients with hypersensitive esophagus, possibly by altering adenosine-mediated nociception.
KW - Adenosine receptor antagonism
KW - Esophageal hypersensitivity
KW - Functional chest pain
KW - Theophylline
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U2 - 10.1023/A:1021017524660
DO - 10.1023/A:1021017524660
M3 - Article
C2 - 12498299
AN - SCOPUS:0036912036
SN - 0163-2116
VL - 47
SP - 2763
EP - 2768
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 12
ER -