The effect of omeprazole on gastro-oesophageal reflux and symptoms during strenuous exercise

Background: Strenuous exercise exacerbates gastro-oesophageal reflux and sy mptoms and this may be diminished by antisecretory medication with omeprazo le, Methods: Fourteen well-trained athletes (13 men, one woman), who indicated suffering from either heartburn, regurgitation or chest pain during competi tion 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 omep razole or a placebo was administered. Two hours after a low-fat breakfast a nd Ih after the last study dose, the trial started with five successive 50- min periods: rest, three running periods on a treadmill, and recovery, Refl ux (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 interv ention, whereas during the second running period this effect was only obser ved with the placebo, Reflux occurred for longer and more frequently with t he 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 a nd 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 refl ux.