PPIs for NUD, the story continues ▸

The efficacy of proton pump inhibitor (PPI) therapy in non-ulcer dyspepsia (NUD) is controversial. For example, there has been one positive (Blum et al, Gut 2000) and one negative (Wong et al, Gut 2002) randomised controlled trial published in Gut. Peura et al have conducted a randomised controlled trial comparing lansoprazole 30 mg once daily, lansoprazole 15 mg once daily, or placebo for eight weeks in 921 NUD patients. They defined NUD as patients with upper abdominal pain or discomfort as their main complaint who had a normal endoscopy. Patients with heartburn were included but not if this was the predominant problem. They reported that 44% experienced complete symptom resolution in their daily diaries with either dose of lansoprazole compared with 29% in the placebo group (number needed to treat  = 6; 95% confidence intervals 4–15).

It …