Continuous 24-Hour Intragastric pH Monitoring in the Evaluation of the Effect of a Nightly Dose of Famotidine, Ranitidine and Placebo on Gastric Acidity of Patients with Duodenal Ulcer

Savarino, Vincenzo; Mela, Giuseppe Sandro; Scalabrini, P.; Timoteo, E. Di; Magnolia, M. R.; Celle, G

doi:10.1159/000199475

Cited by 20 publications

(10 citation statements)

References 16 publications

(23 reference statements)

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“…Three daily meals were given (dinner at 18.00h. breakfast at 08.00 h and lunch at noon); their composition is reported elsewhere [11], Each patient gave his or her informed consent to the study, which also met the approval of the local Ethical Committee.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of the Effects of Placebo, Ranitidine, Famotidine and Nizatidine on Intragastric Acidity by Means of Continuous pH Recording

Savarino¹,

Mela

Zentilin³

et al. 1989

Digestion

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The effects of single daily doses of placebo, nizatidine 300 mg, ranitidine 300 mg and famotidine 40 mg, given at 22.00 h, have been compared in 16 patients with healed duodenal ulcers. Each of them underwent the above treatment on four separate occasions. The three H₂ receptor antagonists showed a significantly higher acid inhibition than placebo (p < 0.003) throughout the whole 24-hour period. Famotidine turned out to be more effective than nizatidine (p < 0.02) in reducing circadian acidity, while there was no difference between ranitidine and nizatidine. The effects of the three H₂ blockers on overnight acidity (from 23.00 to 07.00) were similar to each other, whereas both famotidine (p < 0.003) and ranitidine (p < 0.02) produced more anacidity than nizatidine during the morning hours (from 07.00 to 12.00). The time period elapsed in consecutive minutes above 5.0 pH units during drug-related events was significantly longer with both famotidine (p < 0.01) and ranitidine (p < 0.01) compared to nizatidine. Therefore in the recommended dosages for clinical use the acid suppression of nizatidine was significantly shorter-lasting than that of both ranitidine and famotidine. The major change is represented by the lack of carryover effect of nizatidine on morning acidity.

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Section: Methodsmentioning

confidence: 99%

“…The median drift over 24 h was negligible, that is 0.05 pH units. The remaining features of our meth odology have already been published [12], Intragas tric pH metries started at 17.00 h and lasted for 24 h until 17.00 h on the following day.…”

Section: Ph Monitoringmentioning

confidence: 99%

Comparison of the Effects of Placebo, Ranitidine, Famotidine and Nizatidine on Intragastric Acidity by Means of Continuous pH Recording

Savarino¹,

Mela

Zentilin³

et al. 1989

Digestion

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“…The development of reliable miniature pH electrodes, data loggers with sufficient memory capacity and user-friendly computer programs for the analysis has made it possible to record intragastric pH during a prolonged period in an ambulant setting (8,(15)(16)(17)(18)(19)(20). However, this technique is not suitable for quantifying gastric acid secretion or for determining the chemical composition of the gastric juice.…”

Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 99%

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

Herwaarden¹,

Samsom²,

Smout³

1999

Scandinavian Journal of Gastroenterology

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van Herwaarden MA, Samsom M, Smout AJPM. 24-h recording of intragastric pH: technical aspects and clinical relevance. Scand J Gastroenterol 1999;34 Suppl 230:9-16.Background: Information about gastric acid secretion and gastric acidity can be obtained using several techniques but, presently, continuous intragastric pH recording is probably the one applied most frequently. This paper aims to review the technical aspects and some important applications of intragastric pH monitoring in research and clinical practice. Methods: Literature review. Results: Most studies on intragastric pH are performed with either glass or antimony electrodes. Optimal measurement of 24-h intragastric pH requires accurate calibration of the pH measuring system, exact positioning of the pH electrodes, and a sufficient sample rate. Depending on the aim of the study the results of intragastric pH monitoring are expressed either as median H activity or as median pH values. Gastric acidity shows a circadian rhythm, modified by buffering meals and nocturnal duodenogastric reflux. In health, age, gender and smoking habits are known to influence gastric acidity. In duodenal ulcer disease an increased gastric acidity is found and in patients with gastric ulcer gastric acidity is decreased. In GERD, no relation between reflux oesophagitis and gastric acidity is found. Helicobacter pylori affects intragastric pH most pronounced during acid inhibitory therapy, both in DU patients and in healthy subjects. In the absence of H. pylori the effect of proton-pump inhibitors on intragastric pH is much less than in the presence of the microorganism, whereas the effect of ranitidine on intragastric pH is barely affected by the H. pylori status. Conclusions: Despite some limitations, intragastric pH monitoring provides important information about gastric acidity.

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“…Drugs were begun 48 h before each test in order to simulate clinical therapy conditions, and the morning dose was given before the breakfast. Each patient had three daily meals, which were stan dardized for timing (at 18.00, 08.00 and 12.00 h) and content [10]. Extra food was not allowed.…”

Section: Methodsmentioning

confidence: 99%

Single Morning and Nightly Doses of Ranitidine 300 mg: An Appraisal of Their Antisecretory Effects by Continuous pH Monitoring

Savarino¹,

Mela

Zentilin³

et al. 1991

Digestion

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Gastric acidity of 12 patients with healed duodenal ulcers was continuously monitored over 24 h in order to assess the antisecretory effects of two different administration times of a single daily dose of ranitidine 300 mg. Each patient orally received either (a) placebo at 08.00 h and 22.00 h; (b) ranitidine 300 mg at 08.00 h and placebo at 22.00 h, or (c) placebo at 08.00 h and ranitidine 300 mg at 22.00 h in randomized and double-blind fashion. Each medication was administered on three separate occasions, with intervals of at least 1 week. Both the morning and the bedtime doses of ranitidine were significantly superior (p < 0.001) to placebo in controlling 24-hour gastric acidity, while, in the same period, ranitidine nocte was more effective (p < 0.001) than ranitidine mane. During the night, bedtime ranitidine caused more acid inhibition (p < 0.001) than morning ranitidine, but the opposite (p < 0.01) occurred during the daytime. This study shows that the antisecretory effect of morning ranitidine during the daytime is less consistent than that achieved by bedtime ranitidine during the nocturnal period. As similar rates of duodenal ulcer healing have recently been achieved with morning and conventional nighttime administration of H₂ antagonists, it becomes clear that antisecretory drugs can also be beneficial with an acid inhibition which is shorter-lasting than that which was previously thought to be necessary or, alternatively, that also daytime acidity is important in ulcerogenesis.

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Continuous 24-Hour Intragastric pH Monitoring in the Evaluation of the Effect of a Nightly Dose of Famotidine, Ranitidine and Placebo on Gastric Acidity of Patients with Duodenal Ulcer

Cited by 20 publications

References 16 publications

Comparison of the Effects of Placebo, Ranitidine, Famotidine and Nizatidine on Intragastric Acidity by Means of Continuous pH Recording

Comparison of the Effects of Placebo, Ranitidine, Famotidine and Nizatidine on Intragastric Acidity by Means of Continuous pH Recording

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

Single Morning and Nightly Doses of Ranitidine 300 mg: An Appraisal of Their Antisecretory Effects by Continuous pH Monitoring

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