TY - JOUR T1 - JournalScan JF - Gut JO - Gut SP - 1718 LP - 1718 VL - 53 IS - 11 A2 - , Y1 - 2004/11/01 UR - http://gut.bmj.com/content/53/11/1718.abstract N2 - ▴ Meineche-Schmidt V. Empiric treatment with high and standard dose of omeprazole in general practice: two-week randomized placebo-controlled trial and 12-month follow-up of health-care consumption. Am J Gastroenterol2004;99:1050–8.OpenUrlCrossRefPubMed Empirical proton pump inhibitor (PPI) therapy has been recommended as an appropriate management strategy for uninvestigated dyspepsia. There is a relative paucity of randomised trial data on the optimum dose of PPI in this patient group and little information on long term health economic outcomes. Dr Meineche-Schmidt has addressed this in a trial where 103 general practitioners (GPs) randomised 829 dyspepsia patients to omeprazole 40 mg or 20 mg, or placebo for two weeks. Dyspepsia was defined as any upper gastrointestinal symptom and complete relief of the predominant symptom was achieved in 66%, 63%, and 35% of patients, respectively. There was no significant difference between the different doses of omeprazole but the PPI was superior to placebo with a number needed to treat of less than four. Patients had therapy discontinued after two weeks and were managed as normal by their GP. Those with successful treatment had similar dyspepsia relapse rates and gastrointestinal medication consumption over the next 12 months as those that did not achieve symptom cure. Patients with symptom cure however had less endoscopy, GP consultations, and specialist referrals. The “PPI test” may therefore be useful as patients are … ER -