Managing heartburn at the 'base' of the GERD 'iceberg': effervescent ranitidine 150 mg b.d. provides faster and better heartburn relief than antacids.
BACKGROUND
Many individuals with heartburn self-medicate with antacids for relief of their symptoms.


OBJECTIVE
To compare efficacy of effervescent ranitidine to as-needed calcium carbonate antacids in subjects who self-treat heartburn.


METHODS
A total of 155 subjects with frequent antacid-responsive heartburn were randomized to receive effervescent ranitidine 150 mg tablets b.d., or as-needed calcium carbonate 750 mg for 12 weeks. Endoscopic oesophagitis severity and mucosal histology were assessed at baseline, and at weeks 6 and 12. Heartburn frequency, severity, and antacid consumption were recorded daily, and quality of life was assessed at baseline, and at weeks 6 and 12.


RESULTS
Heartburn frequency and severity were significantly decreased after 1 day of ranitidine (P < 0.02). By week 6, ranitidine had significantly decreased rescue antacid consumption (7.3 tablets, P < 0.001) vs. antacids (14.1 tablets). Endoscopic oesophagitis healing (</= grade 1) was significantly better with ranitidine (55%, P=0.022) vs. antacids (29%). Quality of life was improved by both treatments; however, ranitidine was numerically superior for all quality of life parameters, statistically superior for several quality of life indices at week 6 and for the pain-related index by week 12 (P < 0. 05).


CONCLUSIONS
For subjects self-administering antacids for chronic heartburn, effervescent ranitidine 150 mg b.d. is more effective than antacids in reducing heartburn, healing erosive oesophagitis, alleviating pain, and improving quality of life.
Earnest
D
D
University of Arizona Health Sciences Center, Tucson, AZ, USA.
Robinson
M
M
Rodriguez-Stanley
S
S
Ciociola
A A
AA
Jaffe
P
P
Silver
M T
MT
Kleoudis
C S
CS
Murdock
R H
RH
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000188:drug therapy; D002119:Calcium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D004941:Esophagitis / Q000188:drug therapy; D005260:Female; D006356:Heartburn / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011899:Ranitidine / Q000009:adverse effects / Q000627:therapeutic use*; D012646:Self Administration; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D011899:Ranitidine; D002119:Calcium Carbonate