Theophylline improves esophageal chest pain - A randomized, placebo-controlled study

Satish S.C. Rao, Ranjit S. Mudipalli, Jose M. Remes-Troche, Craig L. Utech, Bridget Zimmerman

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)930-938
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume102
Issue number5
DOIs
StatePublished - May 1 2007

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Theophylline
Chest Pain
Placebos
Hypersensitivity
Pain Threshold
Electric Impedance
Double-Blind Method
Cross-Over Studies
Esophagus
Therapeutics
Pain

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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Theophylline improves esophageal chest pain - A randomized, placebo-controlled study. / Rao, Satish S.C.; Mudipalli, Ranjit S.; Remes-Troche, Jose M.; Utech, Craig L.; Zimmerman, Bridget.

In: American Journal of Gastroenterology, Vol. 102, No. 5, 01.05.2007, p. 930-938.

Research output: Contribution to journalArticle

Rao, Satish S.C. ; Mudipalli, Ranjit S. ; Remes-Troche, Jose M. ; Utech, Craig L. ; Zimmerman, Bridget. / Theophylline improves esophageal chest pain - A randomized, placebo-controlled study. In: American Journal of Gastroenterology. 2007 ; Vol. 102, No. 5. pp. 930-938.
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