[Comparison between histamine H2-blocker and proton pump inhibitor on the effects of initial treatment in reflux esophagitis].Nihon Rinsho. 2000 Sep; 58(9):1847-52.NR
I have reviewed the comparison between histamine H2 blocker(H2-RA) and proton pump inhibitor(PPI) on the effects of initial treatment in patients with reflux esophagitis. Pathophysiology of reflux esophagitis has been thought to be gastroesophageal reflux of the gastric acid, due to motor dysfunctions of the esophagus and the stomach. Endoscopic healing rate of reflux esophagitis is significantly higher 84% on PPI treatment than 52% on H2-RA treatment at 8 weeks period. Because suppression of the gastric acid secretion is significantly stronger and longer on PPI than H2-RA, especially this suppression is markedly found in day time and also night time. On the initial treatment of reflux esophagitis, PPI is choice so-called "step down therapy" after healing, H2-RA and/or prokinetic drugs are treated as maintenance therapy.