Document Detail


Histamine-2 receptor antagonists at night improve gastroesophageal reflux disease symptoms for patients on proton pump inhibitor therapy.
MedLine Citation:
PMID:  16336606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
While night-time symptoms of gastroesophageal reflux disease (GERD) are common, considerable controversy exists regarding the use of histamine-2 receptor antagonists (H2Ras) for night-time reflux control. Some studies have suggested possible tolerance to H2RA while others have suggested that long-term efficacy of gastric acid control can be maintained with night-time H2RA use. The aim of this study was to identify if GERD patients have sustained symptom improvement with long-term use of night-time H2RA. Records of 56 consecutive GERD patients on twice daily proton pump inhibitor (PPI) and night-time H2RA therapy were reviewed. During a phone interview patients were asked a 5-item questionnaire, which included overall assessment of symptoms, night-time symptoms, sleep disturbance, duration and frequency of therapy. Of the 56 patients, 39 (31 women, mean age 56) completed the questionnaire (15 were not reached and 2 did not recall enough information). All respondents had taken night-time H2RA for at least 1 month (28/39 patients with > 6 months duration) with 33/39 patients taking H2RAs every night. The addition of H2RA led to an improvement in overall symptoms in 28/39 (72%) patients, improvement in night-time reflux symptoms in 25/34 (74%) patients and improvement of GERD-associated sleep disturbance in 18/27 (67%) patients. Five (13%) patients had stopped the H2RA on their own, stating that its efficacy waned after 1 month. Our results suggest that the majority of patients report persistent improvement in GERD symptoms from night-time H2RA use and that possible clinically important tolerance to H2RAs occurs in a small number of patients. Further prospective, placebo-controlled studies may help confirm that there is a role for night-time H2RAs in GERD symptom control.
Authors:
A Rackoff; A Agrawal; A Hila; I Mainie; R Tutuian; D O Castell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E     Volume:  18     ISSN:  1120-8694     ISO Abbreviation:  Dis. Esophagus     Publication Date:  2005  
Date Detail:
Created Date:  2005-12-12     Completed Date:  2006-01-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8809160     Medline TA:  Dis Esophagus     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  370-3     Citation Subset:  IM    
Affiliation:
Digestive Diseases Center, Medical University of South Carolina, Charleston, South Carolina 29425, USA. rackoff@musc.edu
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MeSH Terms
Descriptor/Qualifier:
Drug Administration Schedule
Drug Therapy, Combination
Female
Gastroesophageal Reflux / drug therapy*
Histamine H2 Antagonists / adverse effects*
Humans
Interviews as Topic
Male
Proton Pumps / antagonists & inhibitors*
Questionnaires
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Histamine H2 Antagonists; 0/Proton Pumps

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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