Theophylline offers relief for unexplained chest pain

The discomfort caused by esophageal (non-cardiac) chest pain is often severe, driving many patients to emergency rooms and physicians' offices despite the fact that the ailment has no definable pathology.

Although this pain may sometimes be the result of acid reflux disease, when this is absent most patients present hypersensitivity of the esophagus, and a recent study suggests a potential new way of managing this and other symptoms.

The study finds that theophylline, taken either intravenously or orally, appears to reduce esophageal chest pain by relaxing the esophageal wall and decreasing hypersensitivity. Lead author Satish S.C. Rao finds evidence that these beneficial effects may also be influenced by theophylline's actions on adenosine receptors, altering esophageal sensory thresholds at the same time as relaxing the muscles.

Rao notes that "following oral administration, symptomatic improvement was seen in nearly 60 percent of patients, and the drug was reasonably well tolerated," adding that "if a cardiac, pulmonary, musculoskeletal or esophageal source such as acid reflux disease can be excluded, our findings suggest that a trial of theophylline may be effective in relieving chest pain."