A comparative study of cisapride and ranitidine at controlling oesophageal acid exposure in erosive oesophagitis.
BACKGROUND
The severity of gastro-oesophageal reflux disease is generally considered to be related to the extent of oesophageal acid exposure. Current therapies include antisecretory and prokinetic agents. We compared two of these, ranitidine and cisapride, in their ability to lower oesophageal acid exposure in patients with erosive oesophagitis.


METHODS
Seven patients with Savary-Miller's grade II-IV oesophagitis and with oesophageal contact time > or = 8% were studied. Mean lower oesophageal sphincter pressure was 4.6 mmHg. Oesophageal acid contact time was 25.6 +/- 5.6%. Each patient received ranitidine 150 mg b.d., ranitidine 150 mg q.d.s., or cisapride 10 mg q.d.s. in a randomized 3-way cross-over design. Intra-oesophageal pH was monitored during 24 h for each of these treatments in a controlled hospital environment, while consuming a high fat, high calorie diet.


RESULTS
Cisapride and ranitidine at both doses decreased the acid contact time and the number of reflux episodes. However, a minority of patients treated with ranitidine, and none with cisapride, diminished their oesophageal acid contact time to a normal value of < 5%. No treatment significantly decreased nocturnal acid exposure.


CONCLUSIONS
In patients with severe gastro-oesophageal reflux disease both cisapride and ranitidine demonstrably lower oesophageal acid exposure, but neither therapy predictably normalizes it.
Pouderoux
P
P
Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Kahrilas
P J
PJ
D000328:Adult; D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use*; D020117:Cisapride; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology / Q000627:therapeutic use*; D011899:Ranitidine / Q000494:pharmacology / Q000627:therapeutic use*
D000897:Anti-Ulcer Agents; D010880:Piperidines; D011899:Ranitidine; D020117:Cisapride