The effect of omeprazole on gastro-oesophageal reflux and symptoms during strenuous exercise.
BACKGROUND
Strenuous exercise exacerbates gastro-oesophageal reflux and symptoms and this may be diminished by antisecretory medication with omeprazole.


METHODS
Fourteen well-trained athletes (13 men, one woman), who indicated suffering from either heartburn, regurgitation or chest pain during competition running, performed two experimental trials at 2-week intervals using a randomized, double-blind, placebo-controlled crossover design. During the 6 days preceding the trial and on the trial day itself either 20 mg of omeprazole or a placebo was administered. Two hours after a low-fat breakfast and 1 h after the last study dose, the trial started with five successive 50-min periods: rest, three running periods on a treadmill, and recovery. Reflux (percentage time and number of periods oesophageal pH <4) was measured with an ambulant pH system during these periods.


RESULTS
Compared to rest, reflux lasted significantly longer and occurred more frequently during the first running period, irrespective of the intervention, whereas during the second running period this effect was only observed with the placebo. Reflux occurred for longer and more frequently with the placebo than with omeprazole, but this was significant during the first two running periods only. Seven subjects reported heartburn, regurgitation and/or chest pain during exercise, irrespective of the intervention. Only a minority of the symptom periods was actually associated with acid reflux and in all cases this concerned periods with heartburn.


CONCLUSIONS
Running-induced acid reflux, but not symptoms, were decreased by omeprazole, probably because most symptoms were not related to acid reflux.
Peters
H P
HP
Department of Medical Physiology and Sports Medicine, Utrecht University, Utrecht, The Netherlands. h.p.f.peters@med.uu.nl
De Kort
A F
AF
Van Krevelen
H
H
Akkermans
L M
LM
Van Berge Henegouwen
G P
GP
Bol
E
E
Mosterd
W L
WL
De Vries
W R
WR
D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004032:Diet; D004311:Double-Blind Method; D015444:Exercise / Q000502:physiology*; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use*; D010809:Physical Fitness
D000897:Anti-Ulcer Agents; D009853:Omeprazole