Document Detail

On-demand PPI requirements in patients with endoscopy-negative GERD.
MedLine Citation:
PMID:  15365398     Owner:  NLM     Status:  MEDLINE    
GOALS: To evaluate the need for on-demand treatment with proton pump inhibitor in patients with endoscopy-negative GERD. BACKGROUND: Studies indicate that on-demand therapy is suitable for patients without mucosal disease, but the need for PPI in a monotherapy situation is not known. STUDY: Forty-one patients with heartburn and/or acid reflux of more than 3 months duration participated in the study. All were endoscopy-negative and had responded positive to a test with lansoprazole 60 mg x 1 for 7 days. Twenty-four hour pH monitoring was attempted in all, but failed in 4. Twenty-eight had pH <4 more than 4% of the time, 9 had less. During a 3-month period, the patients were allowed to take 1 capsule 30 mg lansoprazole on-demand, maximum 2 capsules a day. The remaining capsules were counted monthly. RESULTS: In the 3-month period, the median mean daily consumption was 1.06 capsule (95% CI: 0072-1.09). No significant difference was found between those with normal or abnormal 24-hour pH-metry. Sixty-three percent used 6 or more capsules a week. CONCLUSION: Patients with longstanding negative-endoscopy reflux disease, whether abnormal or normal 24-hour pH-metry, have symptoms that demand effective therapy. Using PPI on-demand as monotherapy, most patients will need 1 capsule per day.
Paul Juul-Hansen; Andreas Rydning
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  38     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-14     Completed Date:  2005-03-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  746-9     Citation Subset:  IM    
Department of Medicine, Akershus University Hospital, Nordbyhagen, Norway.
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MeSH Terms
Anti-Ulcer Agents / administration & dosage,  therapeutic use*
Drug Administration Schedule
Endoscopy, Gastrointestinal
Gastroesophageal Reflux / complications,  drug therapy*
Heartburn / drug therapy,  etiology
Hydrogen-Ion Concentration / drug effects
Middle Aged
Monitoring, Physiologic
Omeprazole / administration & dosage,  analogs & derivatives*,  therapeutic use*
Prospective Studies
Proton Pumps / antagonists & inhibitors
Treatment Outcome
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Anti-Ulcer Agents; 0/Capsules; 0/Proton Pumps; 103577-45-3/lansoprazole; 73590-58-6/Omeprazole

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