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On‐demand requirements of patients with endoscopy‐negative gastro‐oesophageal reflux disease: H2‐blocker vs. proton pump inhibitor
Author(s) -
JUULHANSEN P.,
RYDNING A.
Publication year - 2009
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 - 10.1111/j.1365-2036.2008.03877.x
Subject(s) - lansoprazole , ranitidine , medicine , proton pump inhibitor , gerd , gastroenterology , reflux , heartburn , endoscopy , omeprazole , disease
Summary Background It is questionable whether a symptomatic condition with few serious medical consequences requires proton pump inhibitor (PPI) treatment. If effective, a less‐potent treatment may be preferable. Aim To compare an H2‐blocker in an effervescent formulation with a PPI in on‐demand treatment of endoscopy‐negative gastro‐oesophageal reflux disease (GERD). Methods Included were patients with heartburn and/or acid regurgitation for at least 3 months duration, a negative endoscopy and a positive response to 7 days of lansoprazole 60 mg daily. Following pH‐metry, the patients were randomized to receive either ranitidine effervescent tablets 75 mg or lansoprazole capsules 15 mg to a maximum of four per day on‐demand. The numbers taken were registered monthly for 6 months. If treatment was unsuccessful (lack of efficacy or side effects), patients were registered as failures. Results One hundred and three patients were included and 63 were considered for statistical analysis; 32 on lansoprazole and 31 on ranitidine. Seventeen (55%) on ranitidine and four (13%) on lansoprazole failed. The average number of tablets per day was 1.2 in the lansoprazole group and 3.1 in the ranitidine group. Conclusions On‐demand treatment in patients with endoscopy‐negative GERD gives a high success rate with a fairly low dose of PPI. The H2‐blocker had significantly less success; nevertheless, almost half were satisfied with the treatment.