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Theophylline Improves Esophageal Hypersensitivity

Oral theophylline decreases number, duration and severity of chest pain episodes

WEDNESDAY, May 16 (HealthDay News) -- Intravenous theophylline appears to reduce non-cardiac chest pain in patients with esophageal hypersensitivity by relaxing the esophageal wall, according to a report in the May issue of the American Journal of Gastroenterology.

Satish S.C. Rao, M.D., Ph.D., of the University of Iowa Hospitals and Clinics in Iowa City, and colleagues used impedance planimetry to assess sensory and biomechanical properties of the esophagus after intravenous infusion of theophylline or placebo in 16 patients with esophageal hypersensitivity. They also conducted a four-week crossover study of oral theophylline compared with placebo in 24 patients.

Patients receiving intravenous theophylline tolerated a significantly higher pressure in the esophagus and showed a more relaxed and deformable esophagus. Patients receiving oral theophylline reported significantly fewer painful days, chest pain episodes, and duration and severity of pain episodes.

"Following oral administration, symptomatic improvement was seen in nearly 60 percent of patients, and the drug was reasonably well tolerated," the authors note. "If a cardiac, pulmonary, musculoskeletal or esophageal source such as acid reflux disease can be excluded, our findings suggest that a trial of theophylline may be effective in relieving chest pain."

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