The 'omeprazole test'

OB/GYN News, Nov 15, 2001 by Selly Koch Kubetin

An "omeprazole test" may be more cost effective than 24-hour pH testing for determining the cause of noncardiac chest pain, Dr. V Alin Botoman said at a gastroenterology update sponsored by the Cleveland Clinic Florida.

The omeprazole test gauges patient response to a 1-week course of omeprazole, 60 mg/day. Some studies suggest that at least half of noncardiac chest pain cases are associated with acid reflux, said Dr. Botoman of the Cleveland Clinic Florida, Fort Lauderdale.

Data on this approach are lacking, but Dr. Botoman said that he has anecdotally observed that psychotropics are as beneficial as proton pump inhibitors when treating noncardiac chest pain. Findings from an uncontrolled study showed that treatment with a proton pump inhibitor and trazodone improved severe, spasmodic chest pains in 80% of a group of patients with "nutcracker esophagus," a motility disorder characterized by high-amplitude peristaltic contractions arising from the distal esophagus.