The "GI Cocktail" is a mixture of medications often given in the Emergency 
Department (ED) for dyspepsia symptoms. Several combinations are used, but the 
most effective has not yet been determined. This study compared three 
combinations commonly given for dyspepsia. The study was a prospective, 
randomized, double-blinded trial comparing antacid (group 1); antacid + Donnatal 
(group 2); antacid + Donnatal + viscous lidocaine (group 3) for acute treatment 
of dyspepsia in the ED. Patients were randomly assigned to receive one of the 
three medication combinations. Patients rated their discomfort on a Visual 
Analog Scale (VAS) immediately before receiving the medication and 30 min later. 
Change in VAS was the primary study endpoint. A 13-mm difference in VAS was 
considered clinically significant. VAS change in the three groups was compared 
using multivariable regression, controlling for pretreatment VAS, study drug, 
previous antacid use, and gastrointestinal (GI) history. One hundred twenty 
patients were enrolled between July and December 2000. One hundred thirteen 
subjects (113) completed the protocol: Group 1 (N = 38); Group 2 (N = 37); Group 
3 (N = 38). There was no statistically significant difference between the groups 
in terms of age, gender, GI history, previous antacid use, or initial degree of 
pain. Group 1 had a 25 +/- 27 mm mean (+/- SD), decrease in pain; Group 2, 23 
+/- 22 mm decrease; and Group 3, 24 +/- 26 mm decrease. There was no 
statistically significant difference in pain relief between the three groups on 
univariate analysis or multivariable regression. In conclusion, the addition of 
Donnatal or Donnatal + lidocaine to an antacid did not relieve dyspepsia better 
than plain antacid. The "GI Cocktail" concoction may not be necessary.