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Cholinergic Therapy of Chronic Heartburn: A Controlled Trial

CDR RAYMOND L. FARRELL; CDR GERALD T. ROLING; and CAPT DONALD O. CASTELL
[+] Article and Author Information

Presented in part at the Annual Meeting of the American Gastroenterological Association, New York, May 1973.

The opinions expressed herein are those of the authors and cannot be construed as reflecting the views of the Navy Department or of the Naval Service at large.

▸Requests for reprints should be addressed to Raymond L. Farrell, M.D., U.S. Naval Hospital, Philadelphia, PA 19145.


Philadelphia, Pennsylvania


Ann Intern Med. 1974;80(5):573-576. doi:10.7326/0003-4819-80-5-573
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Oral bethanechol has been shown to produce a sustained rise in lower esophageal sphincter pressure. We studied its effect on 20 patients with chronic heartburn refractory to usual therapy. All patients had a positive Bernstein test and manometric evidence of lower esophageal sphincter incompetence. In a randomized double-blind crossover study, each patient received either 25 mg bethanechol or placebo four times/day for 2 months; after a 2-month rest period the opposite treatment (drug or placebo) was given for 2 months. The patients' symptoms were evaluated each month of the study. Antacid, taken ad lib., was quantitated monthly. The results showed significant (P < 0.05) improvement in heartburn symptoms and decreased antacid use during bethanechol therapy. Bethanechol may be a welcome addition to therapy of refractory heartburn.

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