[Ranitidine therapeutically effective in functional dyspepsia with reflux-like symptoms].

OBJECTIVE

To investigate the effect of ranitidine in patients with functional dyspepsia according to different subgroups.

SETTING

University Hospital Utrecht, department of gastroenterology.

DESIGN

Prospective double blind cross-over study.

METHOD

Thirty patients with chronic upper abdominal symptoms were included, without somatic cause was found at gastroscopy (no Helicobacter pylori), ultrasonography and blood tests. The mean symptom score of: nausea, vomiting, retrosternal pain, epigastric pain, heartburn, bloating, belching, and early satiety was > or = 2. The patients recorded severity and frequency of the symptoms in a diary. The same diary was used to score the symptoms during treatment with ranitidine (2 dd 150 mg) or placebo, each for 2 weeks with a wash out period of 3 days. 29 patients scored correctly.

RESULTS

13 (43%) patients had dysmotility-like dyspepsia, 5 (17%) reflux-like dyspepsia, and 11 (40%) non-specific dyspepsia (i.e. a combination of dysmotility-like, reflux-like or ulcer-like symptoms). Ranitidine significantly improved the severity of heartburn after two weeks of treatment, as compared to placebo (p = 0.035), notably in the patients with reflux-like dyspepsia. Because of a carry-over effect analysis of the symptoms 'belching' and 'early satiety' was not possible.

CONCLUSION

Within the group of patients with functional dyspepsia a subgroup of reflux-like dyspepsia patients can be identified that responds well to ranitidine.