[Does nocturnal monitoring of gastric pH permit the prediction of therapeutic response in severe duodenal ulcer treated with ranitidine?].
The present work was conducted in patients with severe cimetidine-resistant duodenal ulcer, in order to correlate the response (i. e. healing or no healing of the ulcer) to ranitidine therapy and the results of 24 h gastric pH monitoring performed under therapeutic conditions. Twenty patients who fulfilled the criteria of cimetidine resistance (i. e. with an ulcer not healed after a treatment with cimetidine given at a dose of at least 1 g/d for at least 6 weeks) received 150 mg ranitidine twice daily for 6 weeks and were then controlled endoscopically; ulcer was healed in 8 cases, not healed in 12 cases. Nocturnal gastric acid inhibition was significantly greater in patients who responded to ranitidine than in those whose ulcer did not heal. During daytime the gastric pH profiles were not different between these two groups. Nocturnal pH score was also calculated in each patient by reference to the mean inhibitory effect observed in 8 normal subjects in whom gastric pH was monitored in the same therapeutic conditions. In 7 patients the nocturnal pH score was greater than 10; none of these patients was healed after 6 weeks ranitidine treatment. Among the 13 patients with a pH score lower than 10, 8 had an ulcer healed at the end of the ranitidine course. In 5 cases gastric pH monitoring was repeated after continuation of the ranitidine treatment; healing of ulcer was observed in 4 cases, always associated with a nocturnal pH score lower than 10 (in 2 cases after increasing the dosage of ranitidine).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D002927:Cimetidine; D004351:Drug Resistance; D004381:Duodenal Ulcer / Q000188:drug therapy*; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011899:Ranitidine / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D002927:Cimetidine; D011899:Ranitidine
L'enregistrement nocturne du pH gastrique permet-il de prévoir la réponse thérapeutique des ulcères duodénaux sévères traités par la ranitidine?