A GI Cocktail May be No Better Than an Antacid Alone

The "GI cocktail," a combination of an antacid, an antispasmodic, and a local anesthetic, is a mainstay of emergency department treatment for dyspepsia. But is there any evidence that an antacid alone would not do the trick? In this prospective, randomized, double-blind study, researchers compared the efficacy of an antacid alone, an antacid plus an antispasmodic, and a combination of an antacid, an antispasmodic, and a local anesthetic in adult patients whose treating physician ordered a GI cocktail. Exclusion criteria included suspected cardiac or pulmonary etiologies for pain, pregnancy, warfarin use, gastrointestinal bleeding, and antacid use within 1 hour before ED arrival.

Participants received 30 cc of Mylanta alone, Mylanta with 10 c…