Ranitidine vooral werkzaam bij functionele dyspepsie met klachten passend bij refluxziekten

OBJECTIVE: To investigate the effect of ranitidine in patients with functional dyspepsia according to different subgroups. SETTING: University Hospital Utrecht, department of gastroenterology. DESIGN: Prospective double blind cross-over study. METHOD: Thirty patients with chronic upper abdominal symptoms were included, without somatic cause was found at gastroscopy (no Helicobacter pylori), ultrasonography and blood tests. The mean symptom score of: nausea, vomiting, retrosternal pain, epigastric pain, heartburn, bloating, belching, and early satiety was > or = 2. The patients recorded severity and frequency of the symptoms in a diary. The same diary was used to score the symptoms during treatment with ranitidine (2 dd 150 mg) or placebo, each for 2 weeks with a wash out period of 3 days. 29 patients scored correctly. RESULTS: 13 (43%) patients had dysmotility-like dyspepsia, 5 (17%) reflux-like dyspepsia, and 11 (40%) non-specific dyspepsia (i.e. a combination of dysmotility-like, reflux-like or ulcer-like symptoms). Ranitidine significantly improved the severity of heartburn after two weeks of treatment, as compared to placebo (p = 0.035), notably in the patients with reflux-like dyspepsia. Because of a carry-over effect analysis of the symptoms 'belching' and 'early satiety' was not possible. CONCLUSION: Within the group of patients with functional dyspepsia a subgroup of reflux-like dyspepsia patients can be identified that responds well to ranitidine