TY - JOUR
T1 - Theophylline improves esophageal chest pain - A randomized, placebo-controlled study
AU - Rao, Satish S.C.
AU - Mudipalli, Ranjit S.
AU - Remes-Troche, Jose M.
AU - Utech, Craig L.
AU - Zimmerman, Bridget
PY - 2007/5
Y1 - 2007/5
N2 - BACKGROUND AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Theophylline relaxed the esophageal wall, decreased hypersensitivity, and improved chest pain. Theophylline is effective in the treatment of functional chest pain.
AB - BACKGROUND AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Theophylline relaxed the esophageal wall, decreased hypersensitivity, and improved chest pain. Theophylline is effective in the treatment of functional chest pain.
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U2 - 10.1111/j.1572-0241.2007.01112.x
DO - 10.1111/j.1572-0241.2007.01112.x
M3 - Article
C2 - 17313494
AN - SCOPUS:34247854759
SN - 0002-9270
VL - 102
SP - 930
EP - 938
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 5
ER -