Short course of omeprazole: Better first diagnostic and economic approach to non-cardiac chest pain (NCCP) than endoscopy, manometry, or 24 hour esophagel pH monitoring

The effect of double dose of omeprazole on the course of angina pectoris and treadmill stress test in patients with coronary artery disease — A randomised, double-blind, placebo controlled, crossover trial

“…This clinical response to omeprazole was accompanied by simultaneous significant decrease in number of angina-like chest pain and heartburn episodes, as well as in number of nitroglycerin and antacids doses used in the second week of the every study phase ( Table 2). In the context of known high (about 70-80%) sensitivity and specificity of an empirical therapy with proton pump inhibitors for GER diagnosis in patients with NCCP [19,20,21], these results have empowered us to the conclusion, that at least in 35% subjects GER-induced pain was mistaken for angina. So, the acid GER contribution to experience of angina-like chest pain by our patients with CAD was similar to GER prevalence in general Polish population [29].…”

“…Empirical therapy with proton pump inhibitors, often called "omeprazole test" has confirmed good sensitivity and specificity in diagnosis of acid GER, both in patients with its typical and atypical (i.e. NCCP, cough, laryngitis) symptoms [5,18,19]. Recent double-blind, crossover randomised, controlled placebo trials showed the efficacy of triple-dose of lansoprazole [20] and double-dose of rabeprazole [21] used empirically in patients with NCCP and GER diagnosis.…”

¿Cuál es la utilidad del test de inhibidores de la bomba de protones en el dolor torácico no cardíaco?

“…En estos estudios se utilizaron diferentes IBP como el omeprazol, lansoprazol y rabeprazol. Las dosis utilizadas de omeprazol variaban entre 60 mg a 80 mg al día 7,22 , de lansoprazol entre 30 mg y 90 mg al día 8,9 y 40 mg al día para rabeprazol 10,23 . En este estudio utilizamos como punto de corte un tiempo de más de 4,2% (porcentaje de tiempo total con un pH < 4) para definir pacientes con ERGE, se ha elegido este punto de corte para comparar con más homogeneidad y con la misma metodología usada en los diferentes trabajos que han servido para comparar este estudio.…”

Role of Mixed Reflux and Hypomotility with Delayed Reflux Clearance in Patients with Non-cardiac Chest Pain

“…6,7 Furthermore, in patients with NCCP and endoscopic or pH-metric evidence of GERD, the response of NCCP to proton pump inhibitors (PPIs) has been widely evaluated and considered as satisfactory, with a successful response ranging from 78% to 92%. [8][9][10] On the other hand, NCCP patients without evidence of reflux disease respond poorly to PPIs. 11,12 The intraluminal mechanisms responsible for chest pain remain to be fully elucidated.…”