poor response of non-ulcer dyspepsia cases to gastric acid suppression and its implications on the theories of pathogenesis

ABSTRACT

We conducted a randomized controlled trial on 67 patients with non-ulcer dyspepsia to test the efficacy of both H2-Histamine receptors blockers [cimetidine in this study] and conventional antacids in treating these cases. We found that cimetidine was more effective than antacids and placebo in the first week of treatment. It reduced the number of pain attacks by 28.2% in the first week. These effect were not significant in subsequent weeks. Antacids reduced the pain attacks by 12.7% and increased pain-free days by 10.4% which is not significantly different from placebo [12.9% and 12% respectively]. In subsequent weeks, neither cimetidine nor antacids were more effective than placebo. We conclude that the benefit from cimetidine in treatment of non-ulcer dyspepsia is transient and brief, while antacids are of no benefit in such cases. This shows that the non-uclcer dyspeptic syndrome is not dependent on increased gastric acid secretion