Lack of therapeutic effect of cimetidine in non-ulcer dyspepsia.

Therapeutic effect of cimetidine in non ulcer dyspepsia was studied in a placebo controlled trial. The reduction of pain was statistically significant in both groups during the first week of treatment but no change in subsequent three weeks. It was concluded that cimetidine has no therapeutic advantage over the placebo in dyspeptic patients (JPMA 38: 168,1988). INTRODUCTION Non ulcer dyspepsia is a common clinical problem associated with upper abdominal pain of varying severity, fullness, discomfort, belching, nausea, vomiting and acid regurgitation. Exact diagnosis necessitates extensive investigations to exclude organic diseases like peptic ulcer, cholecystitis, pancreatitis and irritable bowel syndrome. As the pathogenesis of non ulcer dyspepsia is not known, no rational therapy has yet been advocated for this condition. The purpose of this trial was to assess the efficacy of cimetidine in the treatment of dyspepsia. PATIENTS AND METHODS Thirty patients of both sexes, aged 18-50 years presenting with upper abdominal pain of varying severity and a negative endoscopy for ulcer, erosions, reflux oesophagitis or atrophic gastritis were included in this trial. Investigations prior to treatment included abdominal ultrasound, haemoglobin, total leucocyte and platelet counts, serum transaminases and creatinine. Patients meeting the entry criteria were allocated to cimetidine (200mg) or a matching placebo three times a day with meals and at bed time for 4 weeks. A diary card was given for recording the intensity of pain. Intensity was scored as for no pain, 1 for mild, 2 for moderate and 3 for severe pain. No concurrent medication was allowed during the study. Patients were followed up every week for four weeks. Endoscopy and laboratory investigations were repeated at the end of the trial.