Comparison between an antacid with a high neutralizing power alone or in combination with domperidone and ranitidine in the treatment of symptomatic reflux esophagitis

Medical therapy of reflux esophagitis has been mainly directed to the neutralization of refluxing acid with antacids, to the inhibition of gastric acid secretion with antisecretory drugs or to the prevention of gastro-esophageal reflux with prokinetic drugs. In the present study 43 patients with symptomatic reflux esophagitis were randomly treated with either ranitidine (150 mg b.i.d.) or antacids with a high neutralizing power (15 ml q.i.d.) or antacids plus domperidone (20 mg t.i.d.) for 8 weeks. Before and after treatment the severity of dyspeptic symptoms (heartburn, regurgitation, retrosternal pain and dysphagia) and the grade of endoscopic and histologic changes were assessed. No significant differences among the three groups were found as far improvement of symptoms and effect on endoscopic and histological features. In all groups of treatment significant better results were observed in patients who did not smoke and drink alcohol, in comparison with smoking and drinking patients (p <0.01).