Nadeem Iqbal Sheikh, Syed Irfan Ahmed, Muhammad Rizwan Mahmud.
Proton pump inhibition therapy in patients with uninvestigated, non-alarm feature dyspepsia.
J Rawal Med Coll Jan ;7(2):56-8.

Background: To. observe the effect of proton pump inhibitor therapy, administered once or twice daily in patients with uninvestigated dyspepsia. Methods: One hundred and sixty patients with uninvestigated dyspepsia were included in this prospective randomised trial conducted from Sept. 2002 to June 2003. Patients were assigned to two groups, A and B, each comprising 80 patients. Group A patients received Omeprazole 20mg p.o. b.i.d. for eight weeks. Group B patients received Omeprazole 20mg p.o. once daily for the same duration. Patients were asked to report at two week intervals for the duration of the study after which omeprazole was stopped and the patients reviewed after a further four weeks. Response to omeprazole was graded as Good, Average and No Response. Those considered treatment failures were advised upper G.I. endoscopy. Results: Forty seven (59%) of Group A patients reported a good response to treatment while 20 (25%) noted some improvement in their dyspeptic symptoms. 13 (16%) did not respond at all. In Group B, 38 (47.5%) patients responded well, 30 (37.5%) noted some improvement while 12 (15%) showed no response. Forty three percent of our patients who presented four weeks after stopping omeprazole treatment reported recurrence or worsening of dyspepsia. Conclusions: Proton pump inhibitor therapy alleviates symptoms of uninvestigated dyspepsia in a majority of cases. Twice daily omeprazole is superior to a once daily regimen. However, an appreciable number of patients relapse after stopping treatment. Those who fail to respond in the first instance should be advised upper G.I. endoscopy.

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