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Synergy between low-dose ranitidine and antacid in decreasing gastric and oesophageal acidity and relieving meal-induced heartburn.
Aliment Pharmacol Ther. 2001 Sep; 15(9):1365-74.AP

Abstract

BACKGROUND

The pathophysiology of recurrent postprandial heartburn and the basis for the effectiveness of antacids or low doses of histamine H2-receptor antagonists have not been well studied.

METHODS

The selected subjects (n=26) had heartburn more than four times a week for at least 2 months, which was responsive to antacids. Gastric pH and oesophageal pH were measured for 1 h before, during, and 4.5 h after ingestion of a meal over 0.5 h. Heartburn severity was assessed at 15-min intervals beginning at the end of the meal. Each subject randomly received placebo, 75 mg ranitidine, 420 mg calcium carbonate, and ranitidine plus calcium carbonate. Values for pH were converted to acid concentration (mM) and integrated acidity was calculated from the cumulative, time-weighted means of the acid concentrations for every second of the postprandial recording period.

RESULTS

There was a close temporal relationship between heartburn and oesophageal acidity. Most oesophageal acid exposure occurred over a 90-min period that began approximately 45 min after the end of the meal. During this period the gastric acid concentration was less than 5% of maximal. Ranitidine significantly decreased gastric but not oesophageal acidity, whilst antacid significantly decreased oesophageal but not gastric acidity. Ranitidine plus antacid significantly decreased both gastric and oesophageal acidity. Antacid alone and ranitidine plus antacid significantly decreased heartburn severity.

CONCLUSIONS

Determining integrated gastric and oesophageal acidity provides novel information regarding the pathophysiology of meal-induced heartburn as well as the actions of low-dose ranitidine and antacid. For subjects with meal-induced heartburn, treatment with low-dose ranitidine plus antacid is particularly effective in decreasing gastric and oesophageal acidity as well as heartburn severity.

Authors+Show Affiliations

Oklahoma Foundation for Digestive Research, University of Oklahoma Health Sciences Center, Oklahoma City, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11552907

Citation

Robinson, M, et al. "Synergy Between Low-dose Ranitidine and Antacid in Decreasing Gastric and Oesophageal Acidity and Relieving Meal-induced Heartburn." Alimentary Pharmacology & Therapeutics, vol. 15, no. 9, 2001, pp. 1365-74.
Robinson M, Rodriguez-Stanley S, Ciociola AA, et al. Synergy between low-dose ranitidine and antacid in decreasing gastric and oesophageal acidity and relieving meal-induced heartburn. Aliment Pharmacol Ther. 2001;15(9):1365-74.
Robinson, M., Rodriguez-Stanley, S., Ciociola, A. A., Filinto, J., Zubaidi, S., Miner, P. B., & Gardner, J. D. (2001). Synergy between low-dose ranitidine and antacid in decreasing gastric and oesophageal acidity and relieving meal-induced heartburn. Alimentary Pharmacology & Therapeutics, 15(9), 1365-74.
Robinson M, et al. Synergy Between Low-dose Ranitidine and Antacid in Decreasing Gastric and Oesophageal Acidity and Relieving Meal-induced Heartburn. Aliment Pharmacol Ther. 2001;15(9):1365-74. PubMed PMID: 11552907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Synergy between low-dose ranitidine and antacid in decreasing gastric and oesophageal acidity and relieving meal-induced heartburn. AU - Robinson,M, AU - Rodriguez-Stanley,S, AU - Ciociola,A A, AU - Filinto,J, AU - Zubaidi,S, AU - Miner,P B,Jr AU - Gardner,J D, PY - 2001/9/13/pubmed PY - 2001/10/26/medline PY - 2001/9/13/entrez SP - 1365 EP - 74 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 15 IS - 9 N2 - BACKGROUND: The pathophysiology of recurrent postprandial heartburn and the basis for the effectiveness of antacids or low doses of histamine H2-receptor antagonists have not been well studied. METHODS: The selected subjects (n=26) had heartburn more than four times a week for at least 2 months, which was responsive to antacids. Gastric pH and oesophageal pH were measured for 1 h before, during, and 4.5 h after ingestion of a meal over 0.5 h. Heartburn severity was assessed at 15-min intervals beginning at the end of the meal. Each subject randomly received placebo, 75 mg ranitidine, 420 mg calcium carbonate, and ranitidine plus calcium carbonate. Values for pH were converted to acid concentration (mM) and integrated acidity was calculated from the cumulative, time-weighted means of the acid concentrations for every second of the postprandial recording period. RESULTS: There was a close temporal relationship between heartburn and oesophageal acidity. Most oesophageal acid exposure occurred over a 90-min period that began approximately 45 min after the end of the meal. During this period the gastric acid concentration was less than 5% of maximal. Ranitidine significantly decreased gastric but not oesophageal acidity, whilst antacid significantly decreased oesophageal but not gastric acidity. Ranitidine plus antacid significantly decreased both gastric and oesophageal acidity. Antacid alone and ranitidine plus antacid significantly decreased heartburn severity. CONCLUSIONS: Determining integrated gastric and oesophageal acidity provides novel information regarding the pathophysiology of meal-induced heartburn as well as the actions of low-dose ranitidine and antacid. For subjects with meal-induced heartburn, treatment with low-dose ranitidine plus antacid is particularly effective in decreasing gastric and oesophageal acidity as well as heartburn severity. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/11552907/Synergy_between_low_dose_ranitidine_and_antacid_in_decreasing_gastric_and_oesophageal_acidity_and_relieving_meal_induced_heartburn_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2001&volume=15&issue=9&spage=1365 DB - PRIME DP - Unbound Medicine ER -