Helicobacter pylori infection influences symptomatic response to anti-secretory therapy in patients with GORD--crossover comparative study with famotidine and low-dose lansoprazole.
OBJECTIVE
Helicobacter pylori infection was reported to affect gastric acid secretion. We investigated the heartburn symptoms of patients with gastro-oesophageal reflux disease during sequential treatment with 40 mg of famotidine or 15 mg of lansoprazole to clarify whether H. pylori infection influences symptomatic response to anti-secretory therapy.


METHODS
The subjects were 33 gastro-oesophageal reflux disease patients, who had already been treated with a full dose of H2 receptor antagonist. First, famotidine at 20 mg b.i.d. was administered to the patients for 8 weeks. Second, famotidine was replaced with 15 mg of lansoprazole once in the morning for 8 weeks. Finally, 20 mg of famotidine was administered b.i.d. for 8 weeks instead of lansoprazole. Gastro-oesophageal reflux disease symptoms were assessed using an original visual analogue scale.


RESULTS
The sequential symptomatic responses to famotidine and lansoprazole administration indicated that gastro-oesophageal reflux disease symptoms of patients during low-dose lansoprazole treatment were significantly less than those during famotidine treatment. Remission of symptoms was obtained significantly more often by famotidine therapy in patients with H. pylori infection than in patients without H. pylori infection.


CONCLUSIONS
Low-dose lansoprazole is more effective than full-dose famotidine for the control of symptoms in patients with gastro-oesophageal reflux disease, and H. pylori infection influences the symptomatic response to H2 receptor antagonists.
Department of Gastroenterology and Hepatology, Shimane University, School of Medicine, Izumo-shi, Japan. kadachi@med.shimane0u.ac.jp
K
K
Adachi
T
T
Hashimoto
Y
Y
Komazawa
T
T
Mihara
K
K
Furuta
H
H
Fujishiro
S
S
Ishihara
Y
Y
Amano
S
S
Hattori
Y
Y
Kinoshita
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D018592:Cross-Over Studies; D004361:Drug Tolerance; D015738:Famotidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D064747:Lansoprazole; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010147:Pain Measurement; D011446:Prospective Studies; D054328:Proton Pump Inhibitors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D015738:Famotidine; D009853:Omeprazole