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Treatment of reflux oesophagitis of moderate and severe grade with ranitidine or pantoprazole—comparison of 24‐hour intragastric and oesophageal pH
Author(s) -
ARMBRECHT U.,
ABUCAR A.,
HAMEETEMAN W.,
SCHNEIDER A.,
STOCKBRÜGGER R. W.
Publication year - 1997
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1997.00195.x
Subject(s) - ranitidine , pantoprazole , medicine , gastroenterology , gastric acid , proton pump inhibitor , reflux , esophagitis , histamine h2 receptor , stomach , esophageal disease , omeprazole , esophagus , antagonist , receptor , disease
Background: Proton pump inhibiting drugs strongly decrease gastric acid secretion and have proven more effective in the treatment of reflux oesophagitis than H 2 ‐receptor antagonists. Methods: In a double‐blind randomized trial, 24 patients with oesophagitis grade II ( n =15) and III ( n =9) were treated for 4 weeks with either ranitidine 150 mg b.d. ( n =13) or pantoprazole 40 mg o.m. ( n =11). Before the trial and on the last day of medication, 24‐h intra‐, gastric pH and oesophageal pH profiles were performed. Healing was assessed by endoscopy. Results: Pantoprazole increased median gastric pH from 1.7 to 3.9. Virtually no change in gastric pH was seen in the ranitidine group. Pantoprazole reduced the fraction time of pH < 4 in the oesophagus from 21% to 3% ( P =0.0005), and the median number of refluxes from 206 to 56 ( P =0.022). Oesophageal acid exposure was not decreased by ranitidine. Healing of the oesophagitis was seen in 6/11 cases after pantoprazole and in 3/13 cases after ranitidine (N.S.) Conclusion: In patients with oesophagitis of moderate and severe grade, pantoprazole 40 mg o.m. decreases intragastric acidity and gastro‐oesophageal acid reflux more effectively than ranitidine 150 mg b.d.