Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors.

摘要: Aim: Proton pump inhibitors taken twice daily before meals (proton inhibitor b.d. AC) effectively controls daytime gastric pH; however, nocturnal acid breakthrough (NAB) occurs in more than 75% of patients. Adding an H2-blocker at bedtime decreases NAB normal subjects. The efficacy this regimen has not been evaluated GERD aim study was to assess the effects proton b.d., both with and without on intragastric pH occurrence patients. Methods: Prolonged ambulatory studies patients were reviewed. Group A: 60 (mean age 53 years, male 30) taking either omeprazole 20 mg or lansoprazole 30 mg B: 45 49 23) (omeprazole 30 mg) plus (ranitidine 300 mg, famotidine 40 mg nizatidine 300 mg). Eleven during treatment regimens (group C). percentage time pH > 4 per cent analysed. In NAB, its duration associated oesophageal exposure also analysed. Results: Median overnight 51% group A, compared 96% B (P   4 73% A 79.8% (P=0.14). Median >p 4 increased from 54.6% H2RA 96.5% after adding (P=0.0013) C occurred 82% 40% (P < 0.0001). mean significantly shorter (18 ± 6 min) (42 ± 9 min, P=0.04). Summary: Adding a enhanced control decreased regimen. NAB. Conclusion: Adding should be considered who require continued whilst