As a treatment for upset stomach, omeprazole, sold under the trade names Prilosec and Rapinex, provides superior relief to that achieved with ranitidine, sold as Zantac, or with cisapride, sold as Propulsid, Canadian researchers report in the American Journal of Gastroenterology.

Omeprazole belongs to a drug group called proton pump inhibitors, which alter the acidity of the stomach. Ranitidine also affects the acidity, but works by blocking the chemical histamine. Cisapride, by contrast, doesn’t affect the acidity directly, but rather improves the emptying of the stomach.

As a treatment for standard upset stomach, medically known as “Dyspepsia,” proton pump inhibitors are superior to histamine blockers or drugs that improve stomach motion, said lead investigator Dr. Sander J. O. Veldhuyzen van Zanten.

“This is true also for patients without any or minimal symptoms of Heartburn.”

In the new study, Veldhuyzen van Zanten, of Dalhousie University, Halifax, and colleagues examined outcomes of 512 patients with dyspepsia who were randomly assigned to receive omeprazole, ranitidine, cisapride, or inactive “placebo.”

By four weeks, 51 percent of omeprazole-treated patients had experienced complete or near complete resolution of their stomach symptoms. With the other drugs the treatment success rates were much lower - 36 percent for Ranitidine, 31 percent for cisapride and 23 percent for placebo.

In an accompanying editorial, Dr. Nimish Vakil of the University of Wisconsin Medical School, Milwaukee notes that the findings “shed further light on the management of (standard) dyspepsia.”

SOURCE: American Journal of Gastroenterology, July 2005.