Reduction of gastric acid secretion by H2 antagonists, in particular ranitidine, is a well-established treatment for reflux esophagitis. Recently, nizatidine, a new H2 antagonist, has been accepted for the treatment of peptic ulcer, but data concerning its usefulness in the treatment of reflux esophagitis are lacking. We designed a double-blind, randomized, cooperative study to evaluate the efficacy of nizatidine vs ranitidine in the treatment of acid reflux esophagitis. Twenty-six patients (17 men and nine women, age range, 20 to 68 years) with symptoms of reflux, endoscopically proved esophagitis (grade 1 or 2 according to Savary's classification), and pathologic gastroesophageal acid reflux confirmed by 24-hour pH-measurement were admitted. Patients were allocated to treatment with nizatidine or ranitidine 150 mg in the morning and 300 mg at bedtime for eight weeks. The two groups of 13 patients did not differ statistically in sex, age, height, weight, alcohol consumption, duration of symptoms, and antacid intake. There was a statistically significant difference in smokers (ranitidine > nizatidine). The symptoms scores were checked at four and eight weeks. Statistically analysis was applied by the Wilcoxon test for symptoms and chi-square test for endoscopic appearance. Three patients did not return for follow-up. We observed a statistically significant improvement of symptoms (epigastric pain, heartburn, nausea, and regurgitation) between the week before treatment and fourth or eighth week in both groups (no difference between groups). Endoscopic esophagitis was absent in nine of 13 (69%) in the group and seven of 13 (54%) subjects in the ranitidine group. The difference between endoscopic appearance on admission and at the end of the study was statistically significant (no difference between groups). No patients complained of any adverse reaction in either group. We conclude that nizatidine is at least as useful as ranitidine in improving the symptoms and endoscopic injuries of erosive esophagitis.
|Number of pages||5|
|Journal||Current Therapeutic Research|
|Publication status||Published - 1991|
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